阿德福韦酯联合腹水超滤浓缩回输治疗乙型肝炎肝硬化顽固性腹水的临床研究  

CLINICAL OBSERVATION OF ADV COMBINED WITH ASCITES CONCENTRATION RETRANSFUSION IN THE TREATMENT OF REFRACTORY CIRRHOSIS ASCITES

作　　者：王玉兰[1] 张国顺[1] 张学军[1] 史春光[1] 魏丽[1] 李姗姗[1] 李玉林[1] 

机构地区：[1]河北华北煤炭医学院附属医院消化内科,唐山063000

出　　处：《现代预防医学》2011年第3期579-581,共3页Modern Preventive Medicine

基　　金：唐山市科技攻关指令项目(09130202A-3-6)

摘　　要：[目的]观察阿德福韦酯联合腹水超滤浓缩回输法治疗乙型肝炎肝硬化顽固性腹水的疗效。[方法]选择乙型肝炎肝硬化顽固性腹水住院患者94例,随机分为两组,治疗组47例,采用阿德福韦酯+腹水超滤浓缩回输+基础治疗:对照组47例,采用腹水超滤浓缩回输+基础治疗,疗程均为2个月。[结果]两组患者的临床症状均得到较好改善,患者体重及腹围显著下降,24h尿量增加,血浆及腹水中蛋白量增加,治疗组患者门静脉、脾静脉内径及血流量,血浆中HBVDNA及内毒素水平较治疗前显著下降,对照组患者则无明显改善,两组比较差异有统计学意义(P﹤0.05);治疗组患者腹水消退显效者26例,占55.3%,对照组只有7例,占14.8%,两组比较差异有统计学意义(P﹤0.05)。[结论]阿德福韦酯联合腹水超滤浓缩回输治疗肝硬化顽固性腹水有较好疗效,其作用机制可能与改善患者血浆内毒素水平有关。[Objective] To observe the effect of ADV combined with ascites concentration retransfusion in the treatment of refractory cirrhosis ascites. [Methods] Ninety-four inpatients with refractory cirrhosis ascites were randomly divided into two groups, 47 cases in the treatment group were treated with ADV ＋ascites concentration retransfusion＋ basic therapy; 47 cases in the control group were treated with ascites concentration retransfusion＋ basic therapy. The course of treatment was 2 months. [Results] The clinical symptoms of the two groups were better improved. The body weight and abdomen circumference were obviously descended, 24 hours urinary output were increased, albumen in plasma and ascites were also increased.The inner diameter and blood flow in portal vein and splenic vein were obviously descended in treatment group （P﹤0.05）, while those of control group were not obviously improved （P﹥0.05）; The HBVDNA and endotoxin in plasma was obviously descended in treatment group （P﹤0.05）, while that of control group was not obviously improved （P﹥0. 05）. The regression of ascites obviously accounted for 55.3% in treatment group, while that of control group was 14.8%. It was obviously difference （P﹤0.05）. [Conclusion] ADV combined with ascites concentration retransfusion which is used to treat refractory cirrhosis ascites can obviously better improve the clinical symptom. It can make inner diameter and blood flow in portal vein and splenic vein descended, make the endotoxin level in plasma descended. Maybe the mechanism of action is relative with the endotoxin level in plasma.

关 键 词：肝硬化 顽固性腹水 阿德福韦酯 腹水超滤浓缩回输 

分 类 号：R657.31[医药卫生—外科学] R978.7[医药卫生—临床医学]