地塞米松治疗早期慢性重型乙型肝炎的临床研究  

Clinical research of dexamethasone in treatment of patients with early chronic severe hepatitis B

作　　者：袁术生 方平安[1] 陈科帆[1] 刘启如[1] 罗飞[1] 易斌[1] 曾瑜[1] 李佳萌[1] 

机构地区：[1]四川省乐山市人民医院感染科,四川乐山614000

出　　处：《实用医院临床杂志》2014年第6期91-93,共3页Practical Journal of Clinical Medicine

基　　金：四川省乐山市科技局基金资助项目(编号:12-SCG-135)

摘　　要：目的分析地塞米松治疗早期慢性重型乙型肝炎的临床疗效并探讨激素的使用时机与方法。方法 2010年1月至2013年1月我院收治的早期慢性重型肝炎患者300例分为治疗组与对照组各150例,对照组采用常规内科综合治疗,治疗组在此基础上加用地塞米松治疗,观察两组治疗后的血清生化指标、并发症、不良反应以及预后。结果治疗4周后治疗组血清总胆红素、ALT、AST、PT均明显低于对照组(P<0.05),并发症发生率低于对照组(20.0%vs 54.0%,χ2=37.194,P<0.05),治疗有效率明显高于对照组(88.0%vs 64.0%,χ2=23.684,P<0.05)。治疗组使用激素1周后24例患者出现兴奋失眠,经对症处理和停用激素后症状好转;12例出现皮肤痤疮,未作特殊处理,停用激素后好转;6例患者停用激素后出现胆红素反跳,未作特殊处理,继续常规内科治疗,好转出院。对照组无不良反应。结论地塞米松治疗早期重型乙型肝炎,可有效改善临床症状,缩短病程,阻止重型乙型肝炎的进展,可在临床推广。但应注意使用时机与方法,尽量减少激素的不良反应。Objective alyze the nical ffects of de amethasone in trea ent of atients with early chronic severe hepa- titis B and to investigate the timing and method of a hormonal therapy. Methods Three hundred patients with early severe hepatitis treated in our department from January 2010 to January 2013 were randomly assigned to treatment and control groups, 150 in each group. Patients in the control group were given conventional internal medical treatment, while the treatment group was given an addition- al dexamethasone on the basis of conventional internal medical treatment. Serum biochemical values, complications, adverse reactions and prognosis in the two groups were observed before and after treatment. Results Compared with the control group, levels of TBIL, ALT, AST and PT in the treatment group were significantly decreased after four weeks therapy （P 〈 0. 05 ）. Incidence of complications in the treatment group was lower than that in the control group （20. 0% vs. 54. 0% ,X2 = 37. 194, P 〈 0. 05 ）. Efficiency rate in the treatment group was significantly higher than the control group （ 88.0% vs. 64. 0% ,X2 = 23. 684, P 〈 0. 05 ）. There were 24 cases showing excitement insomnia after one week of the hormonal treatment, whose symptoms were improved after symptomatic treatment and hormonal withdrawal. There were 12 cases with acne skin. No special treatment was applied for the patients and their symptom was im- proved after hormone withdrawal. There were 6 cases showing a bilirubin rebound after hormone withdrawal. No special treatment was applied and they were discharged after further conventional internal medical treatment. The control group had no adverse reaction. Con- clusion Dexamethasone can effectively alleviate symptoms, shorten the course of disease and prevent the progress of severe hepatitis. It may be worth a clinical expansion. However, the timing and method should be noted in order to minimize the side effects of dexam- ethasone.

关 键 词：地塞米松 慢性重型乙型肝炎 临床研究 

分 类 号：R516.2[医药卫生—内科学]