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目的 应用联苯双酯治疗慢性乙型肝炎 ,观测停药方法及适当指标对丙氨酸转氨酶 ( AL T)反跳的影响。方法 对 15 1例经联苯双酯治疗满 3个月、AL T恢复正常的慢性乙型肝炎患者进行观察 ,其中 91例天冬氨酸转氨酶( AST)恢复正常。停药方式包括一次性停药 ;逐渐减量至停药。两组均于开始治疗一年后复查肝功能。结果 肝功能复查提示 :15 1例患者 AL T反跳率为 2 9.8% ( 4 5 / 15 1) ,一次性停药组与逐渐减量停药组反跳率分别为 2 8.0 % ( 2 1/75 )和 3 1.6% ( 2 4 / 76) ,两组相比无显著差异 ( P>0 .0 5 )。进一步分析表明 :91例 AST恢复正常者 ,AL T反跳率为6.6% ( 6/ 91) ;AST异常 76例 ,AL T反跳率为 66.7% ( 4 0 / 60 )。AST恢复正常组显著低于异常组 ( P<0 .0 1)。结论 应用联苯双酯治疗慢性乙型肝炎 ,当 AL T恢复正常后 ,是否停药 ,何时停药 ,尚需观察 AST是否恢复正常 ,初步认为 AST恢复正常可作为联苯双酯停药的重要指标 ,而与停药方式无关
OBJECTIVE: To study the effect of bifendate on chronic hepatitis B and to observe the effects of discontinuation and appropriate indices on the rebound of alanine aminotransferase (ALT). Methods A total of 151 patients with chronic hepatitis B who returned to normal after ALT were treated with bifendate for 3 months and 91 aspartate aminotransferase (AST) returned to normal. Discontinuation methods include one-time withdrawal; tapering to withdrawal. Liver function was examined in both groups after one year of treatment. Results The liver function tests showed that the ALT rebound rate was 9.8% (15/15) in 15 patients, and the rebound rate was 28.0% (21 / 75) and 31.6% (2/4/76), respectively. There was no significant difference between the two groups (P> 0.05). Further analysis showed that: 91 cases of normal AST recovery, ALT rebound rate was 6.6% (6/91); AST abnormalities in 76 cases, ALT rebound rate of 66.7% (40/60). AST returned to normal group was significantly lower than the abnormal group (P <0.01). Conclusion Biphenyl Diclofenac treatment of chronic hepatitis B, when the AL T returned to normal, whether the withdrawal, when withdrawal, the need to observe whether the AST returned to normal, that AST return to normal as bifendate drug withdrawal Important indicator, but has nothing to do with the withdrawal method