人工肝血浆滤过透析联合恩替卡韦治疗与单用恩替卡韦在慢加亚急性肝衰竭患者短期抗病毒疗效  

Short term antiviral efficacy of plasma diafiltration combined with entecavir and entecavir alone in patients with chronic and subacute liver failure

作　　者：曾艺军 包龙远 郭声 罗颖敏 ZENG Yijun;BAO Longyuan;GUO Sheng;LUO Yingmin(Department of Hepatology,The Fifth People's Hospital of Ganzhou City,Ganzhou,Jiangxi,341000,China)

机构地区：[1]赣州市第五人民医院肝病科,江西赣州341000

出　　处：《当代医学》2022年第36期148-150,共3页Contemporary Medicine

基　　金：赣州市科技计划项目(赣市科发[2019]60号)。

摘　　要：目的探讨人工肝血浆滤过透析(PDF)联合恩替卡韦(ETV)治疗与单用恩替卡韦在慢加亚急性肝衰竭(ACLF)患者短期抗病毒中的疗效。方法选取2019年9月至2020年12月赣州市第五人民医院肝病科收治的74例ACLF患者作为研究对象,按照随机数字表法分为联合组与单用组,每组37例。联合组给予人工肝PDF联合恩替卡韦治疗,单用组给予恩替卡韦治疗,比较两组肝功能指标、终末期肝病模型(MELD)评分及乙肝病毒脱氧核糖核酸(HBV-DNA)定量。结果治疗后,两组总胆红素(TBil)、胆汁酸(TBA)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组MELD评分、HBV-DNA定量均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论人工肝PDF联合恩替卡韦在ACLF短期抗病毒中疗效显著,可有效改善患者的肝功能,抑制病毒复制。Objective To investigate the efficacy of plasma diafiltration(PDF)combined with entecavir(ETV)and entecavir alone in the treatment of chronic and subacute liver failure(ACLF).Methods 74 patients with ACLF admitted to the Department of Hepatology of the Fifth People's Hospital of Ganzhou from September 2019 to December 2020 were selected as the research subjects,and they were divided into combination group and single use group according to the random number table method,with 37 cases in each group.The combination group was treated with artificial liver PDF combined with entecavir,and the single group was treated with entecavir,The liver function index,model for end-stage liver disease(MELD)score and hepatitis B virus DNA(HBV-DNA)quantification were compared between the two groups.Results After treatment,the levels of total bilirubin(TBil),total bile acid(TBA),alanine aminotransferase(ALT)and aspartate aminotransferase(AST)in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the MELD score and HBV-DNA quantification of the two groups were lower than those of the before treatment,and the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).Conclusion Artificial liver PDF combined with entecavir is effective in the short-term antiviral treatment of ACLF,which can effectively improve the liver function of patients and inhibit virus replication.

关 键 词：慢加亚急性肝衰竭 短期抗病毒 人工肝血浆滤过透析 恩替卡韦 

分 类 号：R575.3[医药卫生—消化系统]