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目的观察拉米夫定治疗慢性乙型重型肝炎的疗效。方法Ⅰ组为治疗组,对20例慢性乙型重型肝炎在采用综合治疗的基础上,加用拉米夫定抗病毒治疗;Ⅱ组为对照组,32例慢性重型肝炎患者仅采用综合治疗,观察两组患者接受不同治疗方法3个月前后血清总胆红素(TB il)、凝血酶原活动度(PTA),统计学分析Ⅰ组治疗前后及两组治疗后均值差异,计算两组的有效率和病死率(有效判定标准:TB il<60μmol/L,PTA>40%),对两组有效率和病死率差异进行χ2检验。结果Ⅰ组治疗后TB il显著降低,与Ⅰ组治疗前相比较差异有统计学意义(P<0.05),与Ⅱ组治疗后相比较,差异有统计学意义(P<0.05)。Ⅰ组治疗后PTA显著升高,与Ⅰ组治疗前相比较,差异有统计学意义(P<0.05),与Ⅱ组治疗后相比较,差异有统计学意义(P<0.05)。I组有效率显著高于Ⅱ组(χ2=13.66,RR=0.03,P<0.01),I组病死率显著低于Ⅱ组(χ2=16.90,RR=10.11,P<0.01)。结论拉米夫定能改善慢性乙型重型肝炎的疗效。
Objective To observe the efficacy of lamivudine in the treatment of chronic severe hepatitis B Methods Ⅰ group was treated with 20 cases of chronic severe hepatitis B on the basis of comprehensive treatment, plus lamivudine antiviral therapy; Ⅱ group as the control group, 32 cases of patients with chronic severe hepatitis using only comprehensive treatment, The levels of total bilirubin and prothrombin (PTA) in three groups before and after treatment were compared between the two groups before and after treatment for three months. The mean difference between the two groups before and after treatment and after treatment was calculated. Efficacy and mortality (valid criteria: TB il <60μmol / L, PTA> 40%), the difference between the two groups of efficiency and mortality were χ2 test. Results The level of TB il in group Ⅰ was significantly lower than that in group Ⅰ (P <0.05), and there was significant difference between group Ⅱ and group Ⅱ after treatment (P <0.05). The PTA in group Ⅰ was significantly higher than that in group Ⅰ after treatment (P <0.05), and there was significant difference compared with that in group Ⅱ after treatment (P <0.05). The effective rate in group I was significantly higher than that in group II (χ2 = 13.66, RR = 0.03, P <0.01). The mortality in group I was significantly lower than that in group II (χ2 = 16.90, RR = 10.11, P <0.01). Conclusions Lamivudine can improve the curative effect of chronic severe hepatitis B