摘要
目的: 从血清生化,病毒学,肝纤维化指标以及肝脏组织病理学改变的角度分析拉米夫定(LMD)治疗慢性乙型肝炎的疗效. 方法: 慢性乙型肝炎患者21例,给予口服LMD100mg/d,连用1a,动态观察服药0, 24和48wk肝功能、乙肝五项、HBV DNA定量、血清肝纤维化指标透明质酸(HA)、层黏蛋白(LN)、Ⅲ型前胶原(PⅢP)和Ⅳ型胶原(ⅣC)的变化,通过肝组织穿刺活检,观察用药前后肝脏组织病理学的改变.结果: LMD治疗48wk,可显著抑制HBV DNA(copy/L)复制(6. 13×109 ±4. 03×105 vs9. 01×105 ±4. 89×103, P<0. 01),使大多数患者肝功能(nkat/L,ALT: 1697±907 vs550±503; AST: 1787±717 vs498±430 )恢复正常(P<0. 01),显著降低血清肝纤维化指标水平(P<0. 01). 减轻肝细胞坏死,汇管区炎细胞浸润及纤维化. 结论: LMD是治疗慢性乙型肝炎的一种较为切实有效的措施.
AIM: To investigate the serum indices changes and liver histopathological changes of chronic hepatitis B patients treated with Lamivudine. METHODS: Twenty-one patients with chronic hepatitis B were selected at random and treated with Lamivudine 100 mg/d for one year. The HBV-DNA copy number, Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activity, as well as HA, LN, PCIII and IVC concentrations were analyzed in sera from patients at baseline, and 24 weeks and 48 weeks after lamivudine treatment. Needle biopsy of liver was performed in eight patients before and after Lamivudine treatment to observe the liver histopathological changes. RESULTS: After the 48 weeks of Lamivudine treatment, ALT and AST levels (nkat/L) reduced from 1697±907 to 550±503 ( P <0.01) and 1787±717 to 498±430 ( P < 0.01) , HBV-DNA level (copy/L, from 6.13×10 9±4.03×10 5 to 9.01×10 5±4.89×10 3) and four hepatic fibrosis markers in serum also significantly decreased ( P <0.01). Patients treated with Lamivudine had an evident decrease of inflammation and fibrosis in portal vein of the liver tissue. CONCLUSION: Lamivudine can treat chronic hepatitis B effectively.
出处
《第四军医大学学报》
北大核心
2005年第7期654-656,共3页
Journal of the Fourth Military Medical University
