摘要
Abstract
OBJECTIVE:To investigate clinical efficacy and safety of tiopronin combined with lamivudine in the treatment of pulmonary tuberculosis complicated with chronic hepatitis B. METHODS:150 cases diagnosed as pulmonary tuberculosis with chronic hepatitis B were randomly divided into group A(drug combination group),group B(lamivudine group)and the group C (control group),with 50 cases in each group. 3 groups were given isoniazid+rifapentine+ethambutol+levofloxacin(2HTELfx/4HT) anti-TB treatment and liver protection treatment,etc. Group B was additionally given Lamivudine tablet orally,0.1 g,qd;group A was additionally given Tiopronin tablet 0.3 g,tid,on the basis of group B. The treatment course of 3 groups lasted for 6 months. Liver damage,serum fibrosis indexes of 3 groups were observed in 3 groups before and after treatment as well as hepatitis B virolo-gy indexes,clinical efficacy and the occurrence of ADR after treatment. RESULTS:After treatment,serum levels of ALT,AST and TBIL weresignificantly increased in group C,significantly decreased in group A,with statistical significance(P<0.05).There was no statistical significance in above indexes of group B before and after treatment(P>0.05). Serum levels of ALT,AST and TBIL after the treatment:group A<group B <group C ,with statistical significance(P<0.05). There were no significant difference in the negative rate of HBsAg,the negative rate of HBeAg,the negative rate of HBV-DNA among 3 groups after treatment (P>0.05). Serum fibrosis indexes of group A and B decreased significantly compared to before treatment,with statistical significance (P<0.05);serum fibrosis indexes after the treatment:group A<group B <group C,with statistical significance (P<0.05). The total effective rate were 94.00%,76.00% and 62.00% respectively in group A,group B and group C,with statistical significance (P<0.05). The incidence of ADR were 14.00%,16.00% and 30.00% respectively,without statistical significance (P>0.05). CONCLUSIONS:Tiopronin combined with lamivudine can significantly reduce liver function damage caused by an-ti-TB drugs. It is conducive to the smooth progress of tuberculosis chemotherapy with fewer adverse reactions.关键词
硫普罗宁/拉米夫定/肺结核/慢性乙型肝炎/肝损伤Key words
Tiopronin/Lamivudine/Pulmonary tuberculosis/Chronic hepatitis B/Liver damage分类
医药卫生
