摘要
[目的]观察抗病毒治疗对应用抗结核药物的HBV DNA阳性病人的临床意义。[方法]选择行2HRZE/4HR治疗的HBV DNA阳性病人78例,随机分为两组,观察组初始合并使用拉米夫定(LAM),对照组初始未合并使用LAM。对两组抗结核治疗中肝损害的发生率、停药率、肝衰竭发生率、HBV DNA载量变化进行分析。[结果]未初始合并使用LAM组肝损害发生率为77.42%,停药率为58.06%,肝衰竭发生率为9.68%,而初始合并使用LAM组肝损害发生率为10.64%,停药率为6.38%,肝衰竭发生率为0.00%,两组肝损率及停药率差异有统计学意义(P<0.01),肝衰竭发生率差异无统计学意义,发现HBV DNA高载量是肝损害、肝衰竭发生的危险因素。[结论]HBV DNA阳性病人抗结核治疗期间容易出现肝损害,初始合并使用LAM抗病毒可有效抑制HBV DNA的复制,有助于病人顺利地渡过整个抗结核治疗过程。
[ Objective] To observe the clinical significance of antiviral therapy on the application of anti -TB drugs in HBV DNA -positive patients. [ Methods] A total of 78 TB patients with positive HBV DNA were randomly divided into two groups. Both groups were given 2HRZE/4HR. The control group were treated without Lamivudine initially, and the observation group were treated with. The data on the rate of liver lesion, the rate of drug withdrawal, the rate of liver failure and variation in HBV DNA load in antituberculosis treatment were retrospectively analyzed. 58.06% drug withdrawal, 9.68% liver failure occurring. [ Results] There was 77. 42% liver lesion, in the cases which were treated without Lamivudine initially ,however there was 10.64% liver lesion, 6.38% withdrawal, 0% liver failure in the cases which were treated with. The liver lesion rate and drug withdrawal rate in the two groups were statistically different （ P 〈 0. 01 ） , while liver failure rate was not. Meanwhile we found high HBV DNA quantity was the risk factor for liver lesion and liver failure. [ Conclusion ] TB patients with positive HBV DNA using an- ti-tuberculosis therapy are more likely to have liver lesion. Antiviral treatment with Lamivudine initially can effectively inhibit the reproduction of HBV DNA, helping patients smoothly through the whole antitubercular treatment process.
出处
《上海预防医学》
CAS
2012年第12期649-652,共4页
Shanghai Journal of Preventive Medicine
