摘要
目的:观察拉米夫定在来氟米特联合甲泼尼龙治疗乙肝相关性肾炎(HBV-GN)患者抗病毒中的疗效及安全性。方法:纳入因HBV-GN接受甲泼尼龙联合来氟米特治疗的41例患者,根据有无抗病毒治疗指征分为预防组及治疗组给予拉米夫定治疗,同时选取15例拉米夫定治疗的慢性乙型肝炎患者作为对照组。观察患者生化学、病毒学及血清学应答情况以及治疗过程中血清IFN-γ及IL-4的变化。结果:治疗48周时,预防组及治疗组生化学、病毒学及血清学应答与对照组比较均无明显差异;预防组及治疗组IFN-γ水平及IFN-γ/IL-4较对照组明显下降(P<0.05)。所有患者均未出现严重不良反应。结论:拉米夫定抗病毒治疗对于使用来氟米特联合激素治疗的HBV-GN患者有较好的疗效及安全性,但来氟米特联合甲泼尼龙抑制机体IFN-γ生产,影响乙肝病毒的清除。
Objective To investigate the efficacy and safety of lamivudine in the patients of hepatitis Bvirus-associated glomerulonephritis （HBV-GN） treated by prednisolone with leflunomide. Methods 41 HBV-GNpatients treated by prednisolone and leflunomide were enrolled in this study. According to the presence of theindications of antiviral treatment, the patients were divided into the prevention group and the treatment groupreceived lamivudine treatment, and another 15 patients with chronic hepatitis B were treated with lamivudine as thecontrol group. The biochemical, virological and serological responses during the process of the treatment and theserum levels of IFN-γand IL-4 were determined. Results No significant differences of biochemical, virological andserological responses in the prevention and treatment groups compared with the control group at 48 weeks aftertreatment. Levels of the IFN-γ and IFN-γ /IL-4decreased significantly in the prevention group and treatmentgroups compared with the control group （P 〈 0.05, respectively）. No serious adverse reactions occurred in all patients,Conclusion The antiviral treatment of lamivudine lead to good curative effect and security in HBV-GN patientsreceived hormones combined with leflunomide treatments, but leflunomide with prednisolone inhibited the productionof IFN-γand removal of hepatitis B virus.
出处
《实用医学杂志》
CAS
北大核心
2014年第17期2822-2825,共4页
The Journal of Practical Medicine
基金
安徽省教育厅资助项目(编号:KJ2012Z249)
关键词
乙肝相关性肾炎
拉米夫定
疗效
安全性
Hepatitis B associated glomerulonephritis
Lamivudine
Curative effect
Security
