【摘要】 目的探讨拉米夫定辅助治疗乙型肝炎病毒(HBV)携带者合并肺结核病的价值。方法 HBV携带者合并肺结核病患者94例,随机分为试验组和对照组,每组47例,两组患者均给予2HRZE/4HR方案进行抗结核治疗,试验组在上述治疗的基础上口服拉米夫定,两组疗程均为6个月。比较两组患者疗效,HBV-DNA阴转率及阴转时间、肺结核指标、肝脏损伤情况。结果试验组治疗总有效率为95.75%,高于对照组的82.98%(P<0.05);试验组的HBV-DNA阴转率为100.00%,高于对照组的89.36%,且试验组HBV-DNA阴转时间为(2.22±1.23)个月,短于对照组的(2.89±1.11)个月(P<0.05);试验组的痰菌阴转率、病灶显吸率分别为97.9%、89.36%,均高于对照组的74.5%、61.7%(P<0.05);试验组的肝损伤率为8.51%,低于对照组的36.17%(P<0.05)。结论拉米夫定辅助治疗HBV携带合并肺结核病能降低肝功能损伤,抑制体内HBV复制,提高痰菌阴转率及病灶显吸率,从而改善总体病情。更多还原

【Abstract】 Objective To explore the values of adjuvant therapy of lamivudine in the hepatitis B virus( HBV) infection combined with pulmonary tuberculosis. Methods A total of 94 patients with HBV infection combined with pulmonary tuberculosis were randomly divided into experimental group or control group,47 cases in each group. All cases received 2HRZE /4HR program for anti pulmonary tuberculosis treatment,based on which the experimental group were added with oral lamivudine,and the treatment lasted for 6 months.Curative effect,HBV-DNA negative conversion rate and negative turn time,index of pulmonary tuberculosis,liver injury rate were compared between the two groups. Results The total effective rate of the treatment group was 95. 75%,higher than that of the control group( 82. 98%,P < 0. 05). The HBV-DNA negative conversion rate of the experimental group was 100%,higher than that of the control group( 86. 36%,P < 0. 05),and the HBV-DNA negative turn time of the experimental group was shorter than that of the control group [( 2. 22 ± 1. 23)months vs.( 2. 89 ± 1. 11) months,P < 0. 05]. The sputum negative conversion rate and lesion absorption rate of the experimental group were higher than those of the control group,respectively( 97. 9% vs. 74. 5%,89. 36% vs. 61. 7%,all P < 0. 05). The liver injury rate of the experimental group was 8. 51%,lower than that of the control group( 36. 17%,P < 0. 05). Conclusion Lamivudine treatment for HBV infection combined with pulmonary tuberculosis can reduce the damage of liver function,inhibit HBV replication in vivo,raise the sputum negative conversion rate and the focus significant absorption rate,thereby improve the overall condition.更多还原