干扰素治疗老年重型病毒性肝炎疗效及对血清肿瘤坏死因子-α及胰岛素样生长因子-Ⅰ的影响观察  

Effects of interferon in the treatment of severe viral hepatitis and the levels of serum TNF-α and IGF-Ⅰ in the elderly patients

作　　者：居峰[1] 姚上志[1] 孙彤[1] 

机构地区：[1]无锡市第五人民医院肝胆三病区,江苏省无锡市214005

出　　处：《实用老年医学》2015年第9期769-772,共4页Practical Geriatrics

摘　　要：目的观察干扰素α-2b注射治疗老年重型病毒性肝炎的临床疗效并探讨其治疗前后肿瘤坏死因子-α(TNF-α)、胰岛素样生长因子-Ⅰ(IGF-Ⅰ)的变化情况。方法选取2012年5月至2014年5月在我院收治的老年重型病毒性肝炎患者54例,随机分为常规治疗组和干扰素治疗组,并选择同期25例健康正常人作为对照组;常规治疗组给予白蛋白及谷胱甘肽等综合治疗,干扰素治疗组在综合治疗的基础上给予干扰素治疗;观察干扰素α-2b治疗前后TNF-α、IGF-Ⅰ的水平,以及相关临床指标包括血清总胆红素(Tbi L)、丙氨酸氨基转移酶(ALT)、凝血酶原活动度(PTA)的变化情况,并与常规治疗组及对照组进行对比。结果干扰素治疗组的死亡率为33.33%,常规治疗组的死亡率为66.67%,2组比较差异有统计学意义。同时干扰素治疗组并发症的发生率也明显低于常规治疗组(P<0.05);干扰素治疗组在治疗2周及4周后肝功能情况明显改善;此外干扰素治疗组可明显降低血清TNF-α及IGF-Ⅰ水平,与常规治疗组比较差异具有统计学意义(P<0.05)。结论干扰素治疗老年重型病毒性肝炎可明显改善肝功能,降低患者的死亡率及并发症发生率,故认为干扰素可作为治疗及缓解老年重型病毒性肝炎病情的一种有效药物。Objective To observe the clinical efficacy of interferon α-2b in the treatment of severe viral hepatitis in the elderly patients,and to investigate the changes of serum TNF-α and IGF-Ⅰ after treatment. Methods Fifty-four elderly patients with severe viral hepatitis in our hospital from May 2012 to May 2014 were randomly divided into conventional treatment group and interferon group,with 27 cases in each group,and 25 cases of healthy people were chosen as control group at the same time. Conventional treatment group was treated with albumin and glutathione. Interferon group was additionally treated with interferon α-2b on the basis of conventional treatment group. Before and after treatment,the levels of TNF-α,IGF-Ⅰ and related indicators（ Tbi L,ALT,PTA） were oberserved and compared among three groups.Results The mortality rate was 33. 33% and 66. 67% in the interferon group and conventional treatment group,respectively. The incidence rate of the complications of interferon group was significantly lower than that of conventional treatment group（ P 〈 0. 05）. The liver function was obviously improved after the treatment with interferon at 2 weeks and 4weeks. The levels of TNF-α and IGF-Ⅰ were more significantly decreased in interferon group than conventional treatment group（ P 〈 0. 05）. Conclusions Interferon α-2b can obviously improve the liver function,reduce mortality and the incidence of complications,so interferon α-2b can be used as an effective drug in the treatment of severe viral hepatitis in the elderly.

关 键 词：重型病毒性肝炎 老年人 干扰素 肿瘤坏死因子-α 胰岛素样生长因子-I 

分 类 号：R512.6[医药卫生—内科学]