胸腺法新联合糖皮质激素治疗乙肝相关性慢加急性肝衰竭临床研究  

Clinical research of thymosin alpha -1 with glucocorticoid in treatment of HBV -related acute -on -chronic liver failure

作　　者：詹金美[1] 石添元[2] 麻少卿[1] 童庆东[1] 孙家敏[1] 

机构地区：[1]龙岩市第二医院感染科一区,福建省龙岩364000 [2]龙岩市第二医院感染科二区,福建省龙岩364000

出　　处：《中国基层医药》2016年第16期2465-2468,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：评价胸腺法新联合糖皮质激素治疗乙肝相关性慢加急性肝衰竭临床疗效及安全性。方法130例乙肝相关性慢加急性肝衰竭患者按数字表法随机分为两组，两组均给予抗病毒治疗、保肝、抗炎、对症等综合治疗；治疗组加用胸腺法新与泼尼松龙。治疗前后观察 HBV 相关性慢加急性肝衰竭患者临床表现、生化指标、凝血酶原活动度（PTA）、HBV DNA 载量、感染和出血、好转率，以4周为观察终点。结果两组治疗前与治疗后比较，血清 TBIL 和 TC 明显改善（t ＝3．12，P ＜0．05和 t ＝3．05，P ＜0．05）；消化道症状改善时间和 TBil 下降时间较对照组明显缩短（t ＝3．34，P ＜0．01和 t ＝4．52，P ＜0．01）；治疗组 ALT、PTA、HBV DNA 载量及继发感染、出血、肝性脑病、肝肾综合征等并发症发生率差异无统计学意义；治疗组有效率75．2％，明显高于对照组的50．3％（χ2＝11．02，P ＜0．01）。结论早期短疗程应用胸腺法新联合糖皮质激素治疗乙肝相关性慢加急性肝衰竭效果好，且不增加并发症的发生率。Objective To evaluate the therapeutic effect of thymosin alpha -1 with glucocorticoid in treat-ment of HBV -related hepatic failure.Methods 130 cases were randomly divided into two groups,they were all giv-en antiviral therapy,protect liver,anti -inflammatory,yellow suit the back support,etc.comprehensive treatment;and patients in treatment group were given thymosin alpha -1 with methyl -prednisone intravenously at the early stage of treating process,and then observed the clinic situation and cure rate of those sufferers,The biochemiccal indicator, PTA and blood serum HBV DNA capacity ending with the period of 4 weeks were tested.Results In both groups,the TBil,TC in serum had apparently improved compared with the baseline after the medication,the difference was signifi-cant （t =3.12,P 〈0.05 and t =3.05,P 〈0.05）.The time of gastrointestinal symptoms improvement and bilirubin subsided time in treatment group were significantly shorter than those of the control group（t =3.34,P 〈0.01 and t =4.52,P 〈0.01 ）.During the treatment,there was no significant adverse reaction,and there were no differences between two groups in Alt,PTA,HBV DNA,infection,gastrointestinal bleeding,hepatic encephalopathy and hepatore-nal syndrome.The effective rate of treatment group was 75.2%,which was higher than 50.3% of the control group （χ2 =11.02,P 〈0.01）.Conclusion Patients with HBV -related hepatic failure of short -term application of thy-mosin alpha -1 with glucocorticoid treatment,can quickly improve symptoms,greatly improve the efficiency of survival rate,shortem hospitalization period,reduce side effects and enhance security.

关 键 词：肝功能衰竭 急性 胸腺法新 糖皮质激素 

分 类 号：R575.3[医药卫生—消化系统] R512.62[医药卫生—内科学]