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目的观察拉米夫定联合激素治疗乙肝相关性膜性肾病的临床疗效。方法 26例乙肝相关性膜性肾病患者给予拉米夫定(100mg,口服,每天1次,连续12个月)治疗7d后加醋酸泼尼松正规治疗(1mg·kg-1·d-1,8周后规律减量)。结果治疗12个月后24h尿蛋白定量(1.60±1.06)g/d较治疗前的(3.80±1.02)g/d明显减少,差异有统计学意义(P<0.05);血浆白蛋白为(39.43±3.21)g/L较治疗前的(22.63±3.74)g/L明显升高,差异有统计学意义(P<0.05);HBV-DNA水平(Lg copy数)由治疗前(2.9±1.8)降至治疗后的(1.2±1.3),差异有统计学意义(P<0.05)。结论拉米夫定联合激素对治疗乙肝相关性膜性肾病有良好疗效。
Objective To observe the clinical efficacy of lamivudine combined with hormone therapy for hepatitis B-associated nephropathy. Methods Twenty-six patients with hepatitis B-associated nephropathy were treated with lamivudine (100 mg orally, once daily for 12 months) for 7 days and then received regular treatment with prednisone acetate (1 mg · kg -1 · d -1, Regular reduction after 8 weeks). Results The urinary protein excretion (1.60 ± 1.06) g / d at 12 months after treatment was significantly lower than that before treatment (3.80 ± 1.02) g / d, the difference was statistically significant (P <0.05) (2.36 ± 3.74) g / L before treatment was significantly higher than that before treatment (P <0.05). The level of HBV DNA (Lg copy) To (1.2 ± 1.3) after treatment, the difference was statistically significant (P <0.05). Conclusion Lamivudine combined with hormones has a good effect on the treatment of hepatitis B-associated nephropathy.