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作 者:程凤英[1]
出 处:《临床内科杂志》2008年第7期484-486,共3页Journal of Clinical Internal Medicine
摘 要:目的探讨慢性重型乙型肝炎抗病毒治疗转归的影响因素及抗病毒治疗对其转归的影响。方法应用回顾性分析的方法,分析165例慢性重型乙型肝炎患者的年龄、凝血酶原活动度(PTA)、血清中HBeAg、抗-HBe滴度,HBVDNA定量,有无并发症,抗病毒治疗等因素与治疗转归的关系。结果慢性乙型重型肝炎患者随年龄的增加、PTA降低、并发症增多,其死亡率明显增高;慢性乙型重型肝炎患者血清HBVDNA定量>1×105copies/ml者其死亡率(52.3%)比HBVDNA<1×105copies/ml的死亡率(32.4%)明显升高;HBeAg,抗-HBe的表达对死亡率无影响;2006年应用拉米夫定抗病毒治疗后慢性乙型重型肝炎HBVDNA定量>1×105copies/ml的患者其死亡率(30.38%)比2002年未使用抗病毒治疗者(54.64%)明显下降。结论影响慢性乙型重型肝炎预后的因素除年龄、PTA和有较多并发症外,患者血清中高病毒载量是影响其死亡率的关键因素,及时抗病毒治疗可以降低死亡率。Objective To investigate the factors related to the outcome of patients with the treatment of antivirus therapy in chronic severe hepatitis B. Method To retrospectively explore the factors including age, prothronabin activity( PTA), serum HBeAg, Anti-HBe, HBV-DNA load, with or without complication and antivims therapy on outcome of 165 patients with chronic severe hepatitis B. Result The mortality of patients at higher age,lower PTA and more complications with chronic severe hepatitis B was significantly higher. The mortality of patients with HBV-DNA more than 1 × 10^5 eopies/ml(52.3% )was higher than those whose HBV-DNA was less than 1 × 10^5 copies/ml( 32. 4% ). There was no correlation between serum HBeAg or anti-HBe and the mortality. The mortality of patients with HBV-DNA more than 1 × 10^5 copies/ml(30.38% ) and treated with lamifudine in 2006 was lower than those whose HBV-DNA was less than 1 × 10^5 copies/ml( 54. 64% ) and treated without any antiviral therapy in 2002. Conclusion Higher serum virus load is the key factors of the mortality instead of other factors including older age, lower PTA and more complication in the patients with chronic severe hepatitis B. The treatment of antivims therapy may be associated with lower mortality.
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