Abstract：Objective To investigate the effect of lamivudine on viral control in patients with chronic hepatitis B acute liver failure. Methods Eight patients with acute hepatitis B liver failure admitted to our hospital from January 2015 to November 2016 were randomly divided into two groups. The control group were treated with conventional treatment measures, while the observation group was treated with the use of lamivudine treatment besides conventional treatment measures. The changes of virological indicators total bilirubin (TBil), serum alanine aminotransferase (ALT), prothrombin activity (PTA) and albumin (Alb) of the two groups were analyzed and detected, and the negative rate after treatment of the two groups were compared. The end-stage liver disease model (MELD) was used to assess the disease improvement after treatment. Results The changes of virological indicators of patients of two groups were obvious before and after the treatment. The levels of ALT and TBil reduced, and levels of PTA and Alb increased. TBil and ALT levels of the observation group after treatment were (188.2±67.5) and mmol/L (92.4± 34.1) U/L, PTA and Alb levels were (50.7±4.9)% and (37.1±4) g/L. The decreases and increases of the observation group were more significant than those in the control group, and the difference was statistically significant (P<0.05). (HBV) quantitative DNA of both groups of patients significantly decreased before and after the treatment. (HBV) quantitative DNA of the observation group was (3.2±0.1) copies/mL after the treatment, while that of the control group was (4±0.2) copies/mL. (HBV) quantitative DNA of the observation group was significantly lower than that of the control group, and there was statistical significance (P<0.05). After treatment, the observation group had 28 cases (70%) (HBV) DNA negative, 14 cases in the control group (35%) with (HBV) DNA negative, and there was statistical significance (P<0.05). After treatment, 27 cases (67.5%) in the observation group improved, and 5 cases died (12.5%). While 16 (40%) cases in the control group improved, and 18 cases died (45%). the mortality of the observation group was lower than that of the control group, and the difference was statistically significant (P<0.05). After treatment, the Child-Pugh score of the observation group was (6.9 ± 1.6) points, significantly lower than that (9.7 ± 1.8), in the control group, with statistical significance (P<0.05). Conclusion The use of lamivudine in the treatment of patients with acute on chronic hepatitis B liver failure, can significantly improve the liver function and virological indicators, promote liver metabolism, improve prognosis effectively, have good clinical effect, reduce the mortality of patients, and improve the clinical efficacy, so it is worthy of promotion.
赵启杰, 叶伟珍, 李伟平. 慢性加急性乙型肝炎肝衰竭患者拉米夫定治疗的病毒控制效果分析[J]. 中国医院统计, 2018, 25(1): 10-13.
Zhao Qijie, Ye Weizhen, Li Weiping. Effect of lamivudine on viral control in patients with chronic hepatitis B acute liver failure. journal1, 2018, 25(1): 10-13.
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