利福昔明改善肝硬化难治型腹水患者临床症状及短期生存情况  

Rifaximin improves clinical symptoms and short-term survival in cirrhotic patients with refractory type ascites

作　　者：王征[1] 侯维[1] 张维[1] 吴浩馨 郑素军[1] 胡中杰[1] Wang Zheng;Hou Wei;Zhang Wei;Wu Haoxin;Zheng Sujun;Hu Zhongjie(First Department of the Liver Disease Center,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京佑安医院肝病中心一科,北京100069

出　　处：《中华肝脏病杂志》2022年第11期1170-1174,共5页Chinese Journal of Hepatology

基　　金：北京市肝病研究所/改革与发展-院所合作项目(Y-2020HZ-2)。

摘　　要：目的探讨利福昔明对肝硬化难治型腹水患者的治疗效果、并发症和24周生存率的影响。方法以回顾性队列研究的方法将62例难治型腹水患者根据实际治疗情况分为利福昔明治疗组42例和对照组20例。利福昔明组患者口服利福昔明α200 mg、4次/d,连续24周。2组其他治疗基本相同。观察2组患者的空腹体质量、腹水情况、并发症和生存率。计量数据两组间比较采用t检验、Mann-WhitneyU检验、重复测量方差分析;计数资料采用χ^(2)检验或Fisher精确概率法进行组间比较;生存率比较采用Kaplan-Meier生存分析。结果利福昔明治疗24周时患者平均体质量减轻3.2 kg,B超测量腹水深度平均减少4.5 cm,对照组24周时平均体质量减轻1.1 kg,B超测量腹水深度平均减少2.1 cm,两组比较差异均有统计学意义(F=4.972,P=0.035;F=5.288,P=0.027)。利福昔明治疗组患者Ⅱ级以上肝性脑病、因腹水加重而住院事件以及自发性细菌性腹膜炎的发生率均明显低于对照组(2.4%与20.0%,χ^(2)=5.295,P=0.021;11.9%与50.0%,χ^(2)=10.221,P=0.001;7.1%与25.0%,χ^(2)=3.844,P=0.050)。利福昔明治疗组24周生存率83.3%,对照组24周生存率60.0%(P=0.039)。结论利福昔明治疗肝硬化难治型腹水患者24周可显著改善腹水症状,降低了肝硬化并发症的发生率,提高24周生存率。Objective To investigate the effects of rifaximin treatment outcomes on complications and 24-week survival rate in cirrhotic patients with refractory type ascites.Methods A retrospective cohort study was conducted on 62 cases with refractory ascites,and were divided into rifaximin treatment group(42 cases)and control group(20 cases)according to the actual treatment conditions.Rifaximin treatment group patients were administered oral rifaximin-α200 mg four times daily for 24 consecutive weeks,and the other treatments were basically the same in both groups.Fasting body weight,ascites,complications and survival rate between the two groups were observed.Measurement data of the two groups using t-test,Mann-Whitney U test,and repeated measures analysis of variance were compared.χ^(2)test or Fisher's exact test were used to compare the enumeration data between the two groups.Kaplan-meier survival analysis was used to compare the survival rates.Results At 24-week of rifaximin treatment,patients average body weight was reduced by 3.2 kg and the average ascites depth was reduced by 4.5 cm with B-ultrasound measurement,while in the control group at 24-week,the average body weight was reduced by 1.1 kg and the average ascites depth was reduced by 2.1 cm with B-ultrasound measurement,and the differences between the two groups were statistically significant(F=4.972,P=0.035;F=5.288,P=0.027).Hepatic encephalopathy incidence of grade II or above,hospitalization rates due to exacerbation of ascites,and spontaneous bacterial peritonitis were significantly lower in the rifaximin treatment group than those in the control group(2.4%vs.20.0%,χ^(2)=5.295,P=0.021;11.9%vs.50.0%,χ^(2)=10.221,P=0.001;7.1%vs.25.0%,χ^(2)=3.844,P=0.050).The 24-week survival rate was 83.3%in the rifaximin treatment group and 60.0%in the control group,P=0.039.Conclusion Rifaximin treatment can significantly improve ascites symptoms,reduce the incidence of cirrhosis complications and improve the 24-week survival rate in cirrhotic patients with refractory typ

关 键 词：肝硬化 难治型腹水 并发症 生存 利福昔明 

分 类 号：R575.2[医药卫生—消化系统]