摘要
目的观察慢性乙型肝炎(乙肝)合并肺结核病患者化疗时联用拉米夫定抗病毒治疗的临床效果。方法收集本院60例临床诊断为乙肝合并肺结核且愿意接受治疗的患者,将研究对象分为化疗联合拉米夫定抗病毒治疗组与单纯化疗组,比较两组患者治疗前后谷丙转氨酶(ALT)、谷草转氨酶(AST)、血清白蛋白(ALB)的变化情况,以及痰菌转阴率、病灶吸收率与不良反应发生率等。结果化疗联合拉米夫定抗病毒治疗组患者治疗后AST、ALT为(13.69±2.16)U/L、(10.91±2.22)U/L,均低于单纯化疗组的(104.58±9.52)U/L、(109.48±3.42)U/L,差异有统计学意义(P<0.05)。化疗联合拉米夫定抗病毒组患者治疗后痰菌转阴率为83.33%、病灶吸收率为76.67%,高于单纯化疗组患者的56.67%、46.67%,差异有统计学意义(P<0.05)。两组患者的头晕乏力、血肌酐升高和肌酸磷酸激酶升高的不良反应发生之间无统计学意义(P>0.05);而化疗联合拉米夫定抗病毒治疗组患者恶心呕吐发生率为6.7%,低于单纯化疗组的26.7%,差异有统计学意义(P<0.05)。结论在化疗基础上联合拉米夫定抗病毒治疗对乙肝合并肺结核患者具有积极的治疗价值。
Objective To observe the clinical effect of chemotherapy combined with lamivudine therapy for chronic hepatitis B complicated with pulmonary tuberculosis. Methods 60 cases of clinical diagnosed hepatitis B complicated with pulmonary tuberculosis were divided into group of chemotherapy combined with lamivudine antiviral therapy and chemotherapy group.The changes of ALT,AST and ALB before and after treatment were compared betweenthe two groups.Sputum negative conversion rate and the focus absorption rate, incidence rate of adverse reaction were also compared.Results AST was（13.69±2.16）U / L in chemotherapy combined with lamivudine group and（104.58±9.52）U / L of simple chemotherapy group was after therapy; the difference was statistically significant（P〈0.05）. After therapy, ALT was（10.91±2.22）U / L in chemotherapy combined with lamivudine group, and was（109.48 ±3.42）U / L in simple chemotherapy group; the difference was statistically significant（P 〈0.05）. Sputum negative conversion rate and the rate of focus absorption were also statistical significance between two groups.Two groups of patients with dizziness, fatigue, elevated serum creatinine and CPK adverse reactions occurred without statistical significance（P〉 0.05）; And chemotherapy combined with lamivudine antiviral treatment group of patients the incidence of nausea and vomiting was 6.7%, lower than that of chemotherapy group（26.7%）, the difference was statistically significant（P〈 0.05）. Conclusion Chemotherapy combined with lamivudine in antiretroviral therapy has positive therapeutic value for hepatitis B patients with pulmonary tuberculosis.
出处
《热带医学杂志》
CAS
2015年第3期362-364,共3页
Journal of Tropical Medicine
关键词
拉米夫定
慢性乙型肝炎
肺结核
lamivudine
chronic hepatitis B
pulmonary tuberculosis
