【摘要】 目的 观察拉米夫定对活动性肝炎肝硬化的治疗效果，寻求治疗活动性肝炎肝硬化的有效方法。方法 选择34例活动性肝炎肝硬化患者，口服拉米夫定100mg，每日1次，疗程12个月。观察治疗前后临床症状、体征、生化指标、病毒学指标、血清肝纤维化标志物以及肝门静脉的宽度、脾静脉的宽度和脾脏厚度变化情况。结果 83.9%(26/31)的患者治疗后病情稳定，生活质量提高。表现为腹水消失或明显减少，黄疸消退或总胆红素明显下降，血清白蛋白升高，丙氨酸氨基转移酶复常或好转。HBV-DNA阴转率51.6%(16/31)，HBeAg阴转率33.3%(7/21)。血清肝纤维化标志物：透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(CⅣ)明显改善(P<0.01)。肝门静脉宽度、脾静脉宽度变窄，部分病例原肿大的脾脏缩小。结论 对于有病毒复制的活动性肝炎肝硬化患者应用拉米夫定治疗，可以改善肝脏功能，延缓或阻止肝硬化进展，减少并发症，提高生活质量。

    【关键词】 肝炎肝硬化；拉米夫定；抗病毒治疗

    The observation of theraputic effect of lamivudine in treatment of hepatitis with hepatic cirrhosis

    LUO Shui-bao,SU Qing-juan,LU Qi-fa,et al.

    Department of Infection,the Fourth Affiliated Hospital,Jiangxi Medical College,Nanchang 330002,China

    【Abstract】 Objective Observe the therapeutic effect by using lamivudine in treatment of hepatitis with hepatic cirrhosis in order to seek for the effective treatment to active hepatitis with hepatic cirrhosis.Methods 34 patients suffering active hepatitis with hepatic cirrhosis were chosen.During the course which lasted 12 months,they were asked to take 100mg lamivudine orally once every day.Clinical symptoms,body signs,indexes of bio-chemistry,virus indexes,and the changes of symbols of serum liver fibrosis,the width of hepatic portal vein,the width of splenic vein,the thickness of spleen before and after the treatment.Results 83.9%(26/31)of the patients’condition became stable after treatment and their living qualities were raised.The details were that ascites disappeared or was reduced obviously.Jaundice or total bilirubin faded.albumin rose,alanine aminotransaminase,ALT got recovered or improved.The rate of HBV-DNA negative-transforming is 51.6%(16/31)and HBeAg is 33.3%(7/21).Symbols of serum liver fibrosis:hyaluronio acid(HA),pre-collagen Ⅲ(PCⅢ) ......