医学毕业论文拉米夫定联合干扰素对慢性乙肝的疗效观察
XX大学 毕业论文 拉米夫定联合干扰素对慢性乙肝的疗效观察 2014年6月25日 拉米夫定联合干扰素对慢性乙肝的疗效观察 作者:段文斌,王伯良,周小平,仲月霞 【关键词】,肝炎 Observation of therapeutic efficacy of lamivudine combined with alpha interferon in patients with chronic hepatitis B [Abstract] AIM: To study the therapeutic efficacy of lamivudine combined with alpha interferon in patients with chronic hepatitis B and to find a new approach to control the disease. S: Eighty chronic hepatitis B patients with HB VDNA and HBeAg positive were divided into two groups: LAM+IFN group treated with lamivudine and alpha interferon for 12 months and LAM group treated with lamivudine alone for 12 months. RESULTS: The therapeutic effect on YMDD mutation in the group with lamivudine and IFNalb was significantly better than that in the group with lamivudine alone(PO.01). CONCLUSION: Lamivudine combined with alpha interferon has better therapeutic efficacy in patients with chronic hepatitis B. [Keywords] hepatitis B, chronic; treatment; lamivudine; interferon 【摘要】目的:了解拉米夫定(LAM)和干扰素对慢性乙肝的疗效,为慢 性乙肝的治疗开辟一条新的途径.方法: 将HBV DNA和HBeAg均阳性的慢 性乙肝患者80例,1 : 1随机分为两组,即治疗组和对照组.其中治疗组(LAM+ 干扰素)为:INFalb,隔日5 MU,im,及LAM 100 mg/d;对照组(LAM组)为LAM 100 mg/d, 口服,共12 mo.结果:LAM和干扰素(治疗组)对YMDD变异 株的治疗作用初步结果明显高于LAM单独作用(对照组)(P0.05).LAM组:40(男25,女15)例,年龄(36.26±1.25) 岁,病程(12.20±1.61) mo, ALT (86.07±1.26),乙肝病毒 e 抗原阳性(40 例)、 乙肝病毒定量阳性(40例);联合治疗组:40(男23,女17)例,年龄(36.18±1.75) 岁,病程(12.01±1.23) mo, ALT (87.25±1.34),为乙肝病毒e抗原阳性(40 例)、乙肝病毒定量阳性(40例). 2.2治疗后在ALT, HBeAg, HBV DNA的变化联合治疗组ALT复常率、HBeAg 和HBV DNA转阴率明显的高于LAM组(P0.01, Tab 1).表1两组治疗后ALT、 乙肝病毒e抗原、乙肝病毒定量方面的比较(略) 2.3肝脏组织病理的变化治疗后两组肝脏组织病理的改善,LAM组为 45.0%(18/40);联合治疗组为87.5%(35/40),联合治疗组肝脏组