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目的拉米夫定耐药对乙肝病毒相关性肾炎治疗的影响。方法 36例HBV相关性肾炎患者同时使用激素及拉米夫定治疗,24周时HBVDNA定量较治疗前下降分为A组23例,上升或不变设为B组13例,测定治疗前及治疗24周、48周时的24h尿蛋白定量,肝肾功能,HBV-DNA定量。结果治疗48周后两组尿蛋白定量下降,血浆白蛋白升高,与治疗前比较差异有统计学意义(P<0.05),但两组之间比较差异无统计学意义(P>0.05);两组治疗前后及两组间血肌酐、谷丙转氨酶比较差异无统计学意义(P>0.05)。结论 24周时拉米夫定耐药的乙肝病毒相关性肾炎患者继续单用该药,仍能取得较好疗效。
Objective To investigate the effect of lamivudine resistance on the treatment of hepatitis B virus associated nephritis. Methods Thirty-six patients with HBV-associated nephritis were treated with steroid and lamivudine. The 24-week serum HBV DNA level was decreased in 23 patients in group A and 13 in group B, unchanged or pre-treatment 24 weeks, 48 weeks when the urinary protein excretion, liver and kidney function, HBV-DNA quantification. Results After 48 weeks of treatment, the urinary protein in both groups decreased and the plasma albumin increased. There was a significant difference between before and after treatment (P <0.05). However, there was no significant difference between the two groups (P> 0.05). There were no significant differences in serum creatinine and alanine aminotransferase between the two groups before and after treatment and between the two groups (P> 0.05). Conclusions Patients with lamivudine-resistant hepatitis B virus-associated glomerulonephritis continue to receive this drug only after 24 weeks.