系统性治疗措施对乙肝患者的临床影响观察与分析  

Observation and Analysis on Clinical Effect of Systemic Treatment on Patients with Hepatitis B

作　　者：林秋菊[1] 

机构地区：[1]海南省海口市人民医院感染科,海南海口570208

出　　处：《实用预防医学》2011年第6期1076-1077,共2页Practical Preventive Medicine

摘　　要：目的探讨系统性治疗措施对慢性乙型重型肝炎患者的临床影响,为慢性乙型重型肝炎治疗提供参考方向。方法 80例慢性乙型重型肝炎患者随机平分为两组,对照组患者给予基础内科治疗,治疗组在此基础上加用替比夫定或拉米夫定抗病毒治疗,比较两组治疗前后临床症状、生存率、TBil(总胆红素)、PTA(凝血酶原活动度)、ALB(白蛋白)及HBV DNA变化,同时观察不良反应情况。结果经过治疗后,治疗组生存率80.0%,对照组生存率60.0%,治疗组生存率较对照组比较差异有统计学意义(P<0.05)。治疗组治疗4～8周后TBil、ALB及PTA指标改善与对照组比较差异均有统计学意义(P<0.05)。治疗组治疗4—8周后病毒复制得到控制,与对照组血清HBV DNA水平比较差异有统计学意义(P<0.05或P<0.01)。两组不良反应情况对比差异无统计学意义(P>0.05)。结论基于拉米夫定、替比夫定与基础内科治疗联合的系统性治疗措施应用于慢性乙型重型肝炎的治疗可提高生存率,加快肝功能好转及HBV DNA水平下降,值得在临床上进一步研究和推广。Objective To discuss the clinical effect of systemic treatment on hepatitis B patients,and to provide the reference for the treatment of chronic severe hepatitis B.Methods Eighty patients with chronic severe hepatitis B were randomly divided into two groups.The control group was treated with basic medical care,while the treatment group was added telbivudine or lamivudine based on the treatment.Before and after the treatment,the clinical symptoms,survival rate,TBil（total bilirubin）,PTA（the original activity of coagulation drunk）,ALB（albumin） and HBV-DNA changes,and adverse reactions were observed and compared between the two groups.Result After the treatment,the survival rates of treatment group and control group were 80.0% and 60.0% respectively,and the difference was statistically significant between the two groups（P〈0.05）.After 4～8 weeks of treatment,the levels of Tbil,ALB and PTA in treatment group were better improved than those in control group,and the difference was statistically significant（P〈0.05）.After 4～8 weeks of treatment,the serum HBV-DNA level in treatment group kept under control,there were statistically significant differences in the serum HBV-DNA level between treatment group and control group（P〈0.05 or P〈0.01）.No statistically significant difference was found in adverse reactions between the two groups（P〈0.05）.Conclusions The systemic treatment based on lamivudine and telbivudine for treating chronic severe hepatitis B can increase the survival rate,speed up the improvement in liver function and decline of serum HBV-DNA.It is worthy of further research and promotion in clinical practice.

关 键 词：慢性乙型重型肝炎 系统性治疗措施 拉米夫定 替比夫定 

分 类 号：R512.6[医药卫生—内科学]