Effect of lamivudine on immune function and liver function in patients with hepatitis B complicated with pulmonary tuberculosis
HAN Meiyu;Department of Infectious Diseases,The Second People's Hospital of Dongying;
Objective To analyze the effects of lamivudine antiviral therapy on immune function and liver function in patients with hepatitis B complicated with pulmonary tuberculosis.Methods A total of146 patients with hepatitis B complicated with pulmonary tuberculosis who were treated in the Second People's Hospital of Dongying city in Shandong province from May 2015 to December 2016 were enrolled. According to the random numbering method,the experimental group and the control group were divided into 73 cases.The control group received conventional anti-tuberculosis treatment,and the experimental group received lamivudine combined with conventional anti-tuberculosis treatment. The liver function indexes,immune function indexes and serum HBV-DNA levels before and after treatment were compared between the 2 groups,and the incidence of adverse reactions was statistically analyzed.Results The data indicated that the levels of 3 liver function indicators of ALT,TBi L and AST increased in 2 groups,and the increase in the control group was greater than in the experimental group after treatment. After 3 months of treatment,the index values of the experimental group were(91.87 ± 13.65) U/L,(65.25 ± 9.58) μmol/L,and(89.51 ± 16.42) U/L,respectively. which were significantly lower than that of the control group(t = 3.247-11.256,P0.05). Both of the CD4+and CD4+/CD8+levels also increased after treatment,however,the CD8+levels decreased and the experimental group decreased evenmore significantly with values of(39.86 ± 5.47)%,1.66 ± 0.14,(23.89 ±4.64)%, respectively. The difference was statistically significant(t = 3.343-10.471,P0.05).To compare levels of serum HBV-DNA after treatment,the results showed that the level of HBV-DNA decreased in the experimental group and increased in the control group. The HBV-DNA content in the experimental group was(3.14±1.25)copies/m L,which was lower than in the control group(t = 25.406,P0.05). Adverse reactions were observed in both groups.The incidence of adverse reactions in the experimental group was 20.55%,while23.29% in the control group. There was no significant difference in the incidence of adverse reactions between the 2 groups(c2= 0.689,P = 0.530).Conclusion Lamivudine antiviral therapy for the treatment of patients with hepatitis B complicated with pulmonary tuberculosis can effectively improve the immune function of patients and reduce the level of HBV-DNA and the degree of liver damage. Lamivudine treatment also enabled to improve liver function of patients.This therapy has good safety and is worthy of the clinical application.
【CateGory Index】： R512.62;R521