Objective To analyze the clinical efficacy of lamivudine combined with prednisone acetate and immunosuppressive agents in the treatment of active hepatitis B associated membranous nephropathy.
Methods A total of 120 patients with active hepatitis B related membranous nephropathy, who admitted to our hospital from January 2016 to June 2018, were enrolled and divided into the three groups according to the patient’s wishes, with 40 cases in each group. The single drug group was treated with lamivudine, the dual-drug group was treated with lamivudine combined with acetic acid, and the triple–drug group was treated with lamivudine combined with prednisone acetate and immunosuppressive agents. The biochemical indicators (24 h urine protein, serum albumin, serum creatinine), HBV–DNA, total effective rate, and incidence of adverse reactions of the three groups were compared.
Results There were no significant differences in the biochemical parameters and HBV–DNA among the three groups before treatment. After the treatment for 3 months, 6 months, 9 months, and 12 months, the differences were statistically significant (all P<0.05), the triple–drug group had the best improvement effect, the single–agent group had the worst improvement effect, and the double–drug group was among them, the differences were statistically significant ( P<0.05); for the total effective rate, the triple–drug group > dual–drug group > single drug group, the differences wer statistically significant ( P<0.05); the incidence of adverse reactions of the three groups were 7.50%, 10.00%, 10.00%, respectively, the differences were not statistically significant ( P>0.05).
Conclusion Lamivudine combined with prednisone acetate and immunosuppressive agents has the better therapeutic effect on the patients with active hepatitis B associated membranous, which is worthy of popularization in future clinical treatment.
摘要： 目的 分析拉米夫定联合醋酸泼尼松及免疫抑制剂治疗活动性乙肝相关性膜性肾病取得的临床疗效。 方法 筛选西宁市第二人民医院2016年1月—2018年6月收治的120例活动性乙肝相关性膜性肾病患者, 根据患者意愿分为采取拉米夫定治疗的单药组、拉米夫定联合醋酸泼尼松治疗的双联用药组、拉米夫定联合醋酸泼尼松及免疫抑制剂治疗的三联用药组各40例, 对三组患者生化指标 (24 h尿蛋白、血白蛋白、血肌酐) 、HBV-DNA、总有效率、不良反应发生率进行对比。 结果 治疗前三组患者生化指标、HBV-DNA差异无统计学意义, 治疗3个月、6个月、9个月、12个月后患者的生化指标和HBV-DNA均较治疗前明显改善, 三组间差异有统计学意义 ( P<0.05) 。三联用药组改善效果最佳、单药组改善效果最差、双联用药组介于其中, 差异均有统计学意义 ( P<0.05) ; 三组总有效率相比较, 三联用药组>双联用药组>单药组, 差异有统计学意义 ( P<0.05), 不良反应发生率分别为7.50%、10.00%、10.00%, 差异无统计学意义 ( P>0.05) 。 结论 活动性乙肝相关性膜性肾病患者采取拉米夫定联合醋酸泼尼松及免疫抑制剂治疗效果更佳, 值得在今后临床治疗工作中推广使用。