拉米夫定联合左旋咪唑涂布剂治疗E抗原阳性儿童慢性乙型肝炎

目的分析拉米夫定联合左旋咪唑涂布剂治疗21例HBeAg阳性儿童慢性乙型肝炎的近、远期疗效。方法采用统一检测方法和评价标准，分析拉米夫定联合左旋咪唑涂布剂治疗HBeAg阳性的儿童慢性乙型肝炎（儿童组）的近期疗效，HBVYMDD发生率及停药后的远期疗效，并与同期治疗的HBeAg阳性成人A组（拉米夫定＋左旋咪唑涂布剂）与成人B组（单用拉米夫定）的相关指标比较，进行，检测和P检验。结果儿童组与成人A组及成人B组治疗结束时血清学、病毒学、生化学单项应答率分别为52．4％、34％、28．5％；90．5％、74．9％、62．8％；85．7％、82．9％、75．9％；完全应答率分别为52．4％、32％、25．5％；HBVYMDD变异率分别为14．3％、18％、32．12％；停药后1年持久应答率分别为90．9％、75％、51．43％。结论对ALT≥正常上限2倍的慢性儿童乙型肝炎，拉米夫定联合左旋咪唑涂布剂近远期疗效均明显优于单用拉米夫定者，应扩大临床验证，谨慎而果断应用。

Lamivudine combined with liniment levamisole in treatment of children with HBEAg positive chronic hepatitis B

Objective To analyze the short and long term therapeutic effects of lamivudine combine with liniment levamisole in treatment of HBeAg positive chronic hepatitis B in 21 cases of children. Method By adopting the uniform detection and standard of evaluation, the short-term effect of lamivudine combined with liniment levamisole treatment for children with HBeAg positive chronic hepatitis B （Group of children） ,the rate of HBV YMDD mutation and the long-term effect after withdrawal of the doses were analysed and compared with those of HBeAg positive adult Group A （ lamivudine ＋ liniment levamisole） and adult Group B （lamivudine only） by using,X^2 test and P test. Result At the end of the treatment the single response rates of serology, virology and biochemistry were 52.4% ,34% ,28.5% ;90.5% ,74.9% ,62.8% ; 85.7% ,82.9% ,75.9%, respectively; the complete response rates were 52.4%, 32% ,25.5% respectively; the rates of HBV YMDD mutation were 14.3%, 18% ,32. 12% respectively. After withdrawal of doses for 1 year, the persistant response rates were 90.9% ,75% ,51.43% respectively. Conclusion For chronic hepatitis B in children with the ALT value of 2 times or more than the upper normal limit, the short and long term response and curative effects of lamivudine combined with liniment levamisole are both significantly higher than that by using lamivudine only. Further clinical study and cautious use were suggested.