糖皮质激素联合替比夫定治疗重型肝炎倾向的慢性乙肝30例临床观察  

Clinical observation of glucocorticoids combined with Telbivudine in the treatment of 30 cases of chronic hepatitis B with tendency towards severe hepatitis

作　　者：朱丽君[1] 

机构地区：[1]河南省安阳市第五人民医院二病区,河南安阳455000

出　　处：《中国医药导报》2012年第17期107-108,110,共3页China Medical Herald

摘　　要：目的观察糖皮质激素联合替比夫定治疗重型肝炎倾向的慢性乙肝的疗效。方法 60例重型肝炎倾向的慢性乙肝患者随机分成治疗组30例,对照组30例,对照组采用常规内科综合治疗,治疗组在对照组的基础上加用替比夫定口服;地塞米松10 mg冲击治疗3～5 d后停用。观察两组治疗前后的血清生化指标变化、不良反应和并发症情况。结果治疗组总有效率为96.67%,对照组为73.33%,两组比较差异有统计学意义(P<0.05);两组治疗后与本组治疗前比较TBIL、ALT有明显差异(P<0.001),治疗后治疗组TBIL与对照组比较差异有统计学意义(P<0.05);治疗组2、4、8周HBV-DNA转阴率与对照组比较差异均有高度统计学意义(P<0.01);并发症对照组发生11例,治疗组发生4例,两组比较差异有统计学意义(P<0.05)。结论糖皮质激素联合替比夫定治疗重型肝炎倾向的慢性乙肝,可有效改善患者临床症状,抑制病毒复制,降低并发症,阻止向重型肝炎发展。Objective To observe therapeutic efficacy of glucocorticoid combined with Telbivudine in the treatment of chronic hepatitis B with tendency towards severe hepatitis.Methods 60 cases of chronic hepatitis B with tendency towards severe hepatitis were randomly assigned to treatment group and control group.Patients in the control group were given conventional medical treatment,while patients in the control group were given additional oral administration of Telbivudine and compulsive therapy of 10 mg hedexamethasone for 3-5 days.Serum biochemical values changes,adverse reactions and complications in the two groups were observed before and after treatment.Results The total effective rate was 96.67% in treatment group,and was significantly different from 73.33% of the control group（P 0.05）;TBIL and ALT were significantly different before and after treatment in both groups（P 0.001）.TBIL values after treatment were significantly different between the two groups（P 0.05）;two weeks,four weeks and eight weeks HBV-DNA negative rate were significantly different between the two groups（P 0.01）;there were 11 cases of complications in the control group and was significantly different from 4 cases of the treatment group（P 0.05）.Conclusion Glucocorticoid combined with Telbivudine can effectively alleviate symptoms,inhibit viral replication and reduce complications when used to treat chronic hepatitis B with tendency towards severe hepatitis.

关 键 词：替比夫定 糖皮质激素 乙型肝炎 

分 类 号：R575.2[医药卫生—消化系统]