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Lamivudine用於慢性B型肝炎伴隨嚴重急性肝炎導致肝功能代償性機能減退患者的成效
Journal Volume
中山醫學雜誌 22:2 民100.06 頁195-203
Date Issued
2012-08-22T04:36:57Z
Abstract
Background: Decompensation of liver function after acute flare of chronic hepatitis B has hazardous outcomes and requires early anti-viral therapy.
Materials and Methods: From January 2006 to January 2008, we enrolled sixty-six patients with decompensated liver function caused by acute flare up of chronic hepatitis B. Lamivudine 100 mg was administered daily for more than 12 months. We made records of age, gender, HBeAg status, HBV DNA level, and liver enzyme and function tests. Biochemical, serological, and virological responses were recorded at 12 months after therapy.
Results: After 12 months treatment with lamivudine, we found a decline in HBV DNA (mean±SD) from 3.30±4.80 log copies/ml to 2.52±8.60 log copies/ml (p<0.05) in HBeAg positive patients. HBV DNA declined from 2.92±4.41 log copies/ml to 1.89±3.94 log copies/ml (p=0.61) in HBeAg negative patients. Thirty-nine patients (59.0%) achieved ALT normalization, 49 patients (74.2%) achieved prothrombin time normalization, 34 patients (51.5%) achieved total bilirubin normalization, 69.2% achieved undetectable HBV DNA, 45.5% achieved HBeAg seroconcevrsion. Twenty-two of the 44 HBeAg negative patients produced anti-Hbe, and nine of the positive patients produced anti-Hbe.
Conclusion: Lamivudine is an effective therapy for patients with acute decompensation cause by a flare up of chronic hepatitis B, and should be administered as early as possible.
目的：評估lamivudine用於慢性B型肝炎伴隨急性肝炎惡化所導致的肝功能代償性機能減退患者的成效。
材料與方法：從2006年1月至2008年1月收集66位慢性B型肝炎伴隨嚴重急性肝炎導致的肝功能代償性機能減退患者，每天使用Lamivudine 100 mg至少12個月，記錄HBeAg、HBV DNA、肝功能變化，治療12個月後分析生化學、血清學和病毒學的反應。
結果：66位患者經治療12個月後，HBeAg呈現陽性反應患者其HBV DNA(mean±SD)由3.3±4.80 log copies/ml降低至2.52±8.60 log copies/ml (p<0.05)，HBeAg呈現陰性反應患者其HBV DNA (mean±SD) 由2.92±4.41 log copies/ml降低至1.89±3.94 log copies/ml (p=0.61)，39位患者(59.0%)ALT達正常值(p<0.05)，49位(74.2%) Prothrombin time達正常值，34位(51.5%)Total bilirubin達正常值，69.2%其HBV DNA無法偵測到，45.5%其HBeAg達到正常血清濃度。44位HBeAg(-)患者產生anti-Hbe有22位，22位HBeAg(+)患者產生anti-Hbe有9位。
結論：Lamivudine用於慢性B型肝炎伴隨嚴重急性肝炎導致肝功能代償性機能減退患者是有效的藥物，應儘早使用。
Materials and Methods: From January 2006 to January 2008, we enrolled sixty-six patients with decompensated liver function caused by acute flare up of chronic hepatitis B. Lamivudine 100 mg was administered daily for more than 12 months. We made records of age, gender, HBeAg status, HBV DNA level, and liver enzyme and function tests. Biochemical, serological, and virological responses were recorded at 12 months after therapy.
Results: After 12 months treatment with lamivudine, we found a decline in HBV DNA (mean±SD) from 3.30±4.80 log copies/ml to 2.52±8.60 log copies/ml (p<0.05) in HBeAg positive patients. HBV DNA declined from 2.92±4.41 log copies/ml to 1.89±3.94 log copies/ml (p=0.61) in HBeAg negative patients. Thirty-nine patients (59.0%) achieved ALT normalization, 49 patients (74.2%) achieved prothrombin time normalization, 34 patients (51.5%) achieved total bilirubin normalization, 69.2% achieved undetectable HBV DNA, 45.5% achieved HBeAg seroconcevrsion. Twenty-two of the 44 HBeAg negative patients produced anti-Hbe, and nine of the positive patients produced anti-Hbe.
Conclusion: Lamivudine is an effective therapy for patients with acute decompensation cause by a flare up of chronic hepatitis B, and should be administered as early as possible.
目的：評估lamivudine用於慢性B型肝炎伴隨急性肝炎惡化所導致的肝功能代償性機能減退患者的成效。
材料與方法：從2006年1月至2008年1月收集66位慢性B型肝炎伴隨嚴重急性肝炎導致的肝功能代償性機能減退患者，每天使用Lamivudine 100 mg至少12個月，記錄HBeAg、HBV DNA、肝功能變化，治療12個月後分析生化學、血清學和病毒學的反應。
結果：66位患者經治療12個月後，HBeAg呈現陽性反應患者其HBV DNA(mean±SD)由3.3±4.80 log copies/ml降低至2.52±8.60 log copies/ml (p<0.05)，HBeAg呈現陰性反應患者其HBV DNA (mean±SD) 由2.92±4.41 log copies/ml降低至1.89±3.94 log copies/ml (p=0.61)，39位患者(59.0%)ALT達正常值(p<0.05)，49位(74.2%) Prothrombin time達正常值，34位(51.5%)Total bilirubin達正常值，69.2%其HBV DNA無法偵測到，45.5%其HBeAg達到正常血清濃度。44位HBeAg(-)患者產生anti-Hbe有22位，22位HBeAg(+)患者產生anti-Hbe有9位。
結論：Lamivudine用於慢性B型肝炎伴隨嚴重急性肝炎導致肝功能代償性機能減退患者是有效的藥物，應儘早使用。