拉米夫定联合舒血宁注射液治疗慢性乙肝的临床研究

拉米夫定联合舒血宁注射液治疗慢性乙肝的临床研究

张国范

【摘要】目的：探讨拉米夫定联合舒血宁注射液治疗慢性乙肝的临床疗效。方法

选择我院慢性乙肝患者83例，以上患者随机分为两组，观察组和对照组。对照片组给予拉米夫定治疗，疗程为48周。治疗组给予拉米夫定联合舒血宁注射液治疗。在治疗前、治疗后的第12、24、48周检查两组患者的肝功能、血清乙肝标志物

和HBV-DNA定量。在治疗前以及治疗后第48周检测YMDD变异株。结果①治疗组治疗后48周ALT复常率与对照组同期比较，差异有统计学意义，P＜0.05。②治疗组患者在治疗后12、24、48周HbeAg转阴率和HbeAg/HbeAb血清转

换与对照组同期比较，差异无统计学意义，P＞0.05。③治疗组治疗48周后

HBV-DNA转阴率与对照组同期比较，差异有统计学，P＜0.05。④治疗组治疗

48周后YMDD变异株发生率与对照组周期比较，差异有统计学，P＜0.05。⑤两组患者治疗后总有效率比较，差异有统计学意义，P＜0.05。结论舒血宁联合拉米夫定治疗慢性乙肝可以提高HBV-DNA阴转率，减少使用拉米夫定治疗后所导致

乙肝病毒YMDD变异的发生，并促进肝功能恢复，疗效显著。%Objective To invesigate the therapeutic effection of shu xue ning injection combined with lamivudine to treat chronic hepatitis B. Methods 83 cases with chronic hepatitis B were selected, andrandomly divided into two groups, observation group and control group. The control group was treated with lamivudene alone, and the observation group was treated with lamivudine comblined with shuxuening infection, both groups received treatment for 48 weeks. The liver function、hepatitis Bmarkers of serum、HBV-DNA quantification were detectedbefore and the point of 12, 24, 48 weeks, after

treating. Observing the condition of YMDD mutation at the beginning of treatment andthepontof 48weeks after treating. Results①After 48 weeks of treatment, the reeovery rates of ALT in the observation group compared with that of the same period in control group.ghere was statistical difference, P<0.05.②The rates of BbeAg turning megative and the rates of HbeAh seroeonversion in the observation group after

12weeks,24weeks,47weeks compared with those of the same period,there was no statistical difference, P>0.05.③The rates of HBV-DNA turning negative in observation group afer 48weeks compared with that of the same period in control group, there was statistical difference,

P<0.05.④After 48 weeks of treatment, the rates of YMDD mutation in the observation group compared with that of the same period in control group. There was statistical difference, P<0.05.⑤After 48 weeks of treatment,the total rate of clinical efficacy in the observation group compared with that of the same period in control group. There was statistical differecne, P<0.05. Conclusions Shuxuening incidence of YMDD mutation caused by application of lamivudeine, and improve the liver funciton, the therapy has significant clinical effection.

【期刊名称】《中国医药指南》

【年(卷),期】2014(000)022

【总页数】2页(P25-26)

【关键词】慢性乙型肝炎;舒血宁;拉米夫定

【作者】张国范

【作者单位】南阳医学高等专科学校第一附属医院感染科，河南南阳473000

【正文语种】中文

【中图分类】R512.62

病毒性肝炎是严重危害人类健康的一种疾病，而慢性乙型肝炎是所有肝炎种类中患病人数最多，造成后果最严重的。本文在应用拉米夫定的基础上给以舒血宁注射液治疗慢性乙肝，观察其临床治疗效果，现报道如下。

1.1 一般资料

选择我院2007年1月至2009年1月慢性乙肝患者83例，以上患者诊断均符合2005年中华医学会传染病与寄生虫学分会、肝病学分会联合修订的《乙型肝炎防治指南》中制定的诊断标准。同时患者还符合：HBV-DNA≥105拷贝/mL，HbeAg阳性，YMDD变异株阴性；2×正常值上限≤ALT≤10×正常值上限；患者

年龄在18～60岁。同时排除：年龄＜18岁或者年龄＞60岁的患者；排除妊娠或者哺乳期妇女；排除乙肝病毒标志物阳性，而肝功能正常的患者；排除血清学检查为肝炎病毒如丙型或者丁型重叠感染的患者；排除合并有肝性脑病、合并有肝癌、水电解质紊乱、消化道出血的患者；排除慢性乙肝中毒和慢性重型肝炎患者。将以上患者随机分为两组，观察组和对照组。其中观察组43例，男23例，女20例，年龄23～52岁，平均年龄为（31.5± 8.2）岁，病程为1～14年，平均病程为（7.1±2.1）年。对照组40例，其中男22例，女18例，年龄22～53岁，平均

年龄为（32.4±7.9）岁，病程为1～15年，平均病程为（6.9±2.8）年。两组患者在性别、年龄、病程等方面差异无统计学意义，具有可比性。

1.2 方法