摘要
目的分析激素联合免疫抑制剂治疗风湿性疾病合并乙肝患者的临床疗效。方法随机选定本院收治的风湿性疾病合并乙肝病毒感染患者210例,2015年4月—2018年4月为研究时段,分对照组1、对照组2、对照组3、试验组1、试验组2、试验组3,每组样本容量35例。对照组1采用小剂量激素、来氟米特、甲氨蝶呤治疗;对照组2采用小剂量激素、硫唑嘌呤治疗;对照组3采用小剂量激素、环孢素治疗。试验组1、试验组2、试验组3分别在对照组1、对照组2、对照组3的基础上加拉夫米定治疗,比较肝功能变化情况、HBV-DNA转阳率、HBe Ag转阳率、临床症状改善情况。结果试验组1、试验组2、试验组3的GGT、ALT、AST水平、HBV-DNA转阳率、HBe Ag转阳率、关节肿胀个数、关节压痛个数均显著较对照组1、对照组2、对照组3低,差异具统计学意义(P <0. 05);对照组2与对照组3相比差异无统计学意义(P> 0. 05);试验组2与试验组3相比差异无统计学意义(P> 0. 05)。结论风湿性疾病合并乙肝病毒感染患者应用小剂量激素和免疫抑制剂治疗期间予以拉米夫定进行预防性抗病毒治疗,可有效减少HBV活动,预防HBV-DNA、HBe Ag转阳,效果显著,值得借鉴。
Ojbective To analyze the effect of hormone combined immunosuppressive agents on rheumatic diseases in patients with hepatitis B.Methods A total of210patients with rheumatic diseases and hepatitis B virus infection were randomly selected from our hospital.From April2015to April2018,the study period was divided into control group1,control group2,control group3and test group1.Test group2,test group3,each group of sample capacity of35cases.Control group1was treated with low-dose hormone,leflunomide and methotrexate;control group2was treated with low-dose hormone and azathioprine;control group3was treated with low-dose hormone and cyclosporine.The experimental group1,the experimental group2and the experimental group3were treated with lavafidine in the control group1,the control group2and the control group3,respectively,and the changes of liver function,HBV-DNA conversion rate,HBeAg conversion rate,clinical Symptoms improve.Results The test group1,the test group2,the test group3GGT,ALT,AST level,HBV-DNA conversion rate,HBeAg conversion rate,joint swelling number,joint tenderness were significantly higher than the control group1,the control group2The control group was low,P<0.05(statistical difference);the control group2was compared with the control group3,P>0.05(not statistically significant);the experimental group2was compared with the experimental group3,P>0.05(no statistics Learning differences).Conclusion The use of lamivudine for prophylactic antiviral therapy during low-dose hormone and immunosuppressive agents in patients with rheumatic diseases and hepatitis B virus infection can effectively reduce HBV activity and prevent HBV-DNA and HBeAg from turning.The effect is remarkable.
作者
吕静
李东升
LV Jing;LI Dongsheng(Ganzhou People's Hospital,Ganzhou 341000,China)
出处
《现代医院》
2018年第12期1806-1808,共3页
Modern Hospitals
基金
江西省卫生计生委科技计划项目(20174045)
