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目的 :探讨拉米夫定联合地塞米松治疗重型乙型肝炎 (SHB)的治疗效果。方法 :将 4 6例SHB患者分成A、B两组。A组在综合治疗基础上加用拉米夫定 10 0mg ,po,qd ,地塞米松 15～ 2 0mg ,静滴 qd ,10d后减量至 10mg静滴qd ,5d后停药 ;B组采用综合治疗。 12周后观察疗效。结果 :A组的生存率为 (73.9% ,17/ 2 3)优于B组 (39.1% ,9/ 2 3) (P <0 .0 5 ) ;存活者中 ,A组的HBV DNA阴转率 (82 .4 % ,13/ 17)明显优于B组 (2 2 .2 % ,2 / 9) (P <0 .0 1) ;A组的肝功能及PTA的改善优于B组(P <0 .0 5 )。结论 :拉米夫定联合地塞米松可改善SHB的肝功能及PTA ,提高存活率。
Objective: To investigate the therapeutic effect of lamivudine combined with dexamethasone in the treatment of severe hepatitis B (SHB). Methods: 46 SHB patients were divided into A and B groups. Group A was given lamivudine 10 ~ 20mg, po, qd and dexamethasone 15 ~ 20mg on the basis of comprehensive treatment, qd, qd after 10d and 10mg intravenous qd, and stopped after 5d; Group B Comprehensive Treatment. After 12 weeks to observe the effect. Results: The survival rate of group A was significantly higher than that of group B (73.9%, 17/23) (39.1%, 9/2 3) (P <0.05) (82.4%, 13/17) were significantly better than those in group B (22.2%, 2/9) (P <0.01). The improvement of liver function and PTA in group A was better than that in group B P <0. 05). Conclusion: Lamivudine combined with dexamethasone can improve liver function and PTA of SHB and improve survival rate.