医药学论文：促肝细胞生长素联合拉米夫定治疗乙型重型肝炎42例的疗效观察

【摘要】 目的 观察促肝细胞生长素联合拉米夫定治疗乙型重型肝炎的临床疗效。 方法 选择乙型重型肝炎病人83例，随机分成两组。对照组采用综合治疗，治疗组在对照组的基础上加用促肝细胞生长素120mg/d静滴，拉米夫定口服100mg/d，两组疗程均为1个月，观察治疗前后临床、生物化学、病毒学指标变化。 结果 （1）治疗组TBIL、ALT、AST明显下降，TBIL下降较对照组更显著（P< 0.05）；（2）凝血酶原活动度、白蛋白增加较对照组显著（P< 0.05）；（3）HBV-DNA阴转率和负荷载量下降较对照组明显（P< 0.001）；（4）治疗组病死率明显低于对照组（P< 0.001）（11.90%对36.58%）。 结论 促肝细胞生长素联合拉米夫定治疗重型肝炎可使临床症状、体征、肝功能有明显改善，抑制HBV复制，提高生存率。

 

【关键词】 乙型重型肝炎;促肝细胞生长素;拉米夫定

 

Observation of therapeutic effect of lamivudine combined with P-HGF on 42 patients with severe hepatitis B

 

【Abstract】 Objective To observe the clinical effect of lamivudine combined with P-HGF(hepatolyte growth-promoting factor ) therapy on severe hepatitis B. Methods 83 patients with severe hepatitis B were enrolled and randomized into therapeutic group (n=42) and control group (n=41). The therapeutic group was given lamivudine 100mg daily combined with P-HGF 120mg ivgtt daily, the control group was only given the same combined therapy as the therapeutic group while without being given lamivudine and P-HGF for 1 month.Efficacy was assesssd by clinic,biochemical and virologic parameters. Results (1)After 1 month treatment there was obviously decreasing in TBIL, ALT and AST, especially, the TBIL decreasing in therapeutic group were higher than in control group (P＜0.05). (2)PTA and albumin increasing in the therapeutic group were higher than in control group (P＜0.05). (3)HBV-DNA negative sero-conversion rate and loading volume decreasing in the therapeutic group were more higher than in control group(P＜0.001). (4)Fatality rates in the therapeutic group was lower than in control group (11.90%vs 36.58%,P＜0.001). Conclusion Preliminary data indicates that lamivudine with P-HGF (hepatolyte growth-promoting factor) therapy on severe hepatitis B can significantly improve clinical symptoms, signs and liver function, at the same time, can effectively inhibit HBV replication and improve survival rate.

 

【Key words】 severe hepatitis B;P-HGF;lamivudine

 

重型肝炎病情危重，变化急剧，并发症多，病死率高。如何阻止病情的恶性发展，一直是临床所探讨的课题。作者应用促肝细胞生长素联合拉米夫定治疗重型肝炎，取得了较好的效果，现报告如下。