甲泼尼龙联合抗病毒药物治疗对乙型肝炎早期肝衰竭患者肝功能及炎性因子的影响  

Effects of Methylprednisolone Combined with Antiviral Therapy on Liver Function and Inflammatory Factors in Patients with Early Hepatitis B Liver Failure

作　　者：张雄乐[1] 陈芬兰 林文[1] ZHANG Xiongle;CHEN Fenlan;LIN Wen(Department of Infectious Diseases,Fuqing City Hospital,Fuqing 350300,China)

机构地区：[1]福建省福清市医院感染科,福建福清350300

出　　处：《中国医药指南》2023年第34期98-101,共4页Guide of China Medicine

摘　　要：目的 分析甲泼尼龙联合抗病毒药物治疗对乙型肝炎早期肝衰竭患者肝功能及炎性因子的影响。方法 选取80例乙型肝炎早期肝衰竭患者,均为我院2020年1月至2022年12月所收治,按照入院先后顺序将其分为对照组(40例)与研究组(40例),其中对照组仅接受恩替卡韦治疗,研究组则接受甲泼尼龙联合恩替卡韦治疗,运用SPSS 21.0软件比较两组的临床疗效、实验室主要检查指标、终末期肝病模型(MELD)评分、炎性因子及药物不良反应。结果 相比于对照组,研究组的治疗有效率更高(χ^(2)=6.6462,P=0.0099);相比于对照组,研究组治疗后的总胆红素(TBIL)、谷丙转氨酶(ALT)、白蛋白、凝血酶原时间(PT)、高迁移率族蛋白B1(HMGB1)、白细胞介素-1β(IL-1β)、单核细胞趋化蛋白-1(MCP-1)水平及MELD评分更低(P <0.05),而HBV-DNA水平则更高(P <0.05)。在不良反应方面,两组比较差异无统计学意义(P> 0.05)。结论 乙型肝炎早期肝衰竭患者在接受抗病毒药物治疗时,联合应用甲泼尼龙治疗能使临床疗效显著提高,不仅能改善肝功能,有效减轻炎性反应,而且不良反应并不会明显增加。Objective To analyze the effects of methylprednisolone combined with antiviral drugs on liver function and inflammatory factors in patients with early hepatitis B liver failure.Methods Eighty patients with early hepatitis B liver failure,all of whom were admitted to our hospital from January 2020 to December 2022,were divided into control group(40 cases)and study group(40 cases)according to the order of admission.The control group received only entecavir treatment,while the study group received methylprednone combined with entecavir treatment.SPSS21.0 software was used to compare the clinical efficacy,laboratory main test indicators,model for end-stage liver disease(MELD)score,inflammatory factors and adverse drug reactions of the two groups.Results Compared with the control group,the treatment efficiency of the study group was higher(χ^(2)=6.6462,P=0.0099).Compared with the control group,the levels of TBIL,ALT,albumin,PT,HMGB1,IL-1β,MCP-1 and MELD score in the study group after treatment were lower(P<0.05),while the levels of HBV-DNA were higher(P<0.05).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusions When patients with early hepatitis B liver failure are treated with antiviral drugs,the combined application of methylprednisolone can significantly improve the clinical efficacy,not only improve liver function and effectively reduce inflammation,but also the adverse reactions will not increase significantly.It can be considered to promote it,and further explore more reasonable dosage and course of hormone use.

关 键 词：乙型肝炎 肝衰竭 甲泼尼龙 抗病毒药物 肝功能 炎性因子 

分 类 号：R512.62[医药卫生—内科学]