短程糖皮质激素干预乙型肝炎相关早期肝衰竭的临床疗效  

Effect of short term glucocorticoid in the treatment of patients inearly stage of HBV related acute-on-chronic liver failure

作　　者：吴令杰[1] 陈瑞烈[1] 张海生[1] 郭耿龙[1] 赵资德 WU Ling-jie;CHEN Rui-lie;ZHANG Hai-sheng(Infection deparment of Shantou central hospital,Shantou 515031,China)

机构地区：[1]汕头市中心医院感染科

出　　处：《吉林医学》2020年第3期565-567,共3页Jilin Medical Journal

摘　　要：目的:探讨短程使用糖皮质激素对乙型肝炎病毒(HBV)相关的早期慢性肝衰竭及急性肝衰竭的疗效。方法:选择58例住院患者,分为对照组(n=29)及治疗组(n=29),对照组采用恩替卡韦联合使用抗炎保肝等常规治疗,治疗组在对照组的治疗基础上短程使用注射用甲泼尼龙0.5~1 mg/(kg·d)治疗5 d。观察两组患者干预前后的血清总胆红素(TBIL)、ALT、AST、PT、4周生存率、合并症及不良反应发生率等指标。结果:治疗组患者经治疗后各时间点的血清ALT、AST、TBIL、PT均低于对照组,差异有统计学意义(P<0.05)。第3天,治疗组的血清ALT、AST、TBIL下降幅度大于对照组,差异有统计学意义(P<0.05)。短程使用糖皮质激素不增加药物不良反应。治疗组的4周生存率优于对照组,差异有统计学意义(P<0.05)。结论:在HBV相关慢加急性肝衰竭早期短程使用糖皮质激素有助于改善患者预后,提高4周生存率。Objective To investigate the effect of short term glucocorticoidin the treatment of patients inearly stageof HBV related acute-on-chronic liver failure.Method Fifity-eight patients with early hepatitis B related liver failure were included and divided into two groups,control group(n=29)and treatment group(n=29).The control group was treated with entecavir and anti-inflammatory and hepatoprotective drugs.The treatment group received intravenous methylprednisolone 0.5~1 mg/(kg·d)for five days on the basis of Control group.The treatment effect of HBV related acute-on-chronic liver failure,serum TBIL,AST and ALT,prothrombin time,survival rate within 4 weeks,incidence of adverse reactions,before and after intervention were compared between two groups.Results After treatment,the levels of ALT,AST,TBIL and PT of treatment groups were significantly lower than control groups(P<0.05).The serum concentrations of TBIL,ALT and AST in treatment group decreased significantly,compared with the control groupat 3rd day(P<0.05).Short-term use of glucocorticoids not increase adverse-drug-reactions.The 4-week survival rate of the case group was better than that of the control group(P<0.05).Conclusion The short-term glucocorticoid treatment can improve 4-week survival rate of patients in early-stage HBV-relatedacute-on-chronic liver failure.

关 键 词：短程 糖皮质激素 慢加急性肝衰竭 乙型肝炎病毒 

分 类 号：R512.62[医药卫生—内科学] R575.3[医药卫生—临床医学]