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目的:观察拉米夫定治疗慢性乙型肝炎的临床疗效。方法:随机选择慢性乙型肝炎患者5 0例,给予口服拉米服定10 0 mg/ d,连用1a,动态观察服药0、6、12个月肝功能、HBV- DNA定量、血清肝纤维化指标透明质酸(HA)、层粘蛋白(L N)、型前胶原(P P)和 型胶原( C)的变化,对其中10例治疗前后行肝组织穿刺活检,观察肝脏组织学的改变。结果:与对照组相比,拉米夫定治疗组治疗后AL T、AST水平下降,HBV- DNA定量和4项血清肝纤维化指标均明显降低(P<0 .0 1)。肝细胞坏死、汇管区炎细胞浸润及纤维化明显减轻。结论:拉米夫定治疗慢性乙型肝炎,可以明显降低血清HBV- DNA及转氨酶水平,延缓肝组织纤维化的进展,减轻肝组织的炎症坏死。
Objective: To observe the clinical efficacy of lamivudine in the treatment of chronic hepatitis B. Methods: A total of 50 patients with chronic hepatitis B were randomly selected. Oral lamivudine was administered orally at 10 mg daily for 1, 6, and 6 months. The liver function, HBV DNA quantification, serum hepatic fibrosis The changes of hyaluronic acid (HA), laminin (LN), procollagen (PP) and collagen (C) in 10 cases were observed before and after treatment. Liver biopsy was performed to observe the changes of liver histology. Results: Compared with the control group, the levels of ALT and AST decreased, the levels of HBV DNA and four markers of serum hepatic fibrosis were significantly decreased in the lamivudine treatment group (P <0.01). Liver cell necrosis, portal area inflammatory cell infiltration and fibrosis significantly reduced. Conclusion: Lamivudine treatment of chronic hepatitis B can significantly reduce serum HBV DNA and transaminase levels, delay the progression of hepatic fibrosis and reduce the inflammatory necrosis of liver tissue.