中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2014年
8期
6-7,8
,共3页
丁岗强%康谊%刘俊平%曾艳丽%侯环荣%魏君锋%尚佳
丁崗彊%康誼%劉俊平%曾豔麗%侯環榮%魏君鋒%尚佳
정강강%강의%류준평%증염려%후배영%위군봉%상가
乙肝病毒耐药%慢性重型肝炎%抗病毒治疗%临床疗效
乙肝病毒耐藥%慢性重型肝炎%抗病毒治療%臨床療效
을간병독내약%만성중형간염%항병독치료%림상료효
Drug-fast hepatitis B virus%Chronic severe hepatitis%Antiviral therapy%Clinical effect
目的：分析乙肝病毒耐药导致慢性重型肝炎的抗病毒治疗临床疗效。方法：选取本院2009年12月-2012年12月收治的73例于院外口服核苷类似物进行抗乙肝病毒治疗后出现慢性重型肝炎的患者为研究对象，按照入院顺序分为对照组38例和观察组35例。对照组给予常规的保肝、减黄、营养支持等对症治疗，观察组在对照组的基础上继续给予核苷类似物恩替卡韦治疗。比较两组治疗后死亡率、HBV-DNA阴转率及两组患者治疗前后谷丙转氨酶（ALT）、血清总胆红素（T-BILI）、白蛋白（ALB）、凝血酶原活动度（PTA）等肝功能指标变化。结果：治疗24周后，观察组死亡率2.86%，明显低于对照组的18.42%（X2=4.523，P=0.036），HBV-DNA阴转率88.57%，明显高于对照组的39.47%（X2=16.408，P=0.000）。两组患者治疗前ALT、ALB、TBIL、PTA比较差异均无统计学意义（P>0.05）。经过治疗后，对照组患者的ALT、TBIL均明显高于观察组，而ALB、PTA均明显低于观察组，差异均有统计学意义（P<0.05）。结论：对于乙肝病毒耐药导致慢性重型肝炎的患者，抗病毒药物可以降低患者死亡率、提高患者HBV-DNA阴转率，促进肝脏生化功能提高，值得临床上推广应用。
目的：分析乙肝病毒耐藥導緻慢性重型肝炎的抗病毒治療臨床療效。方法：選取本院2009年12月-2012年12月收治的73例于院外口服覈苷類似物進行抗乙肝病毒治療後齣現慢性重型肝炎的患者為研究對象，按照入院順序分為對照組38例和觀察組35例。對照組給予常規的保肝、減黃、營養支持等對癥治療，觀察組在對照組的基礎上繼續給予覈苷類似物恩替卡韋治療。比較兩組治療後死亡率、HBV-DNA陰轉率及兩組患者治療前後穀丙轉氨酶（ALT）、血清總膽紅素（T-BILI）、白蛋白（ALB）、凝血酶原活動度（PTA）等肝功能指標變化。結果：治療24週後，觀察組死亡率2.86%，明顯低于對照組的18.42%（X2=4.523，P=0.036），HBV-DNA陰轉率88.57%，明顯高于對照組的39.47%（X2=16.408，P=0.000）。兩組患者治療前ALT、ALB、TBIL、PTA比較差異均無統計學意義（P>0.05）。經過治療後，對照組患者的ALT、TBIL均明顯高于觀察組，而ALB、PTA均明顯低于觀察組，差異均有統計學意義（P<0.05）。結論：對于乙肝病毒耐藥導緻慢性重型肝炎的患者，抗病毒藥物可以降低患者死亡率、提高患者HBV-DNA陰轉率，促進肝髒生化功能提高，值得臨床上推廣應用。
목적：분석을간병독내약도치만성중형간염적항병독치료림상료효。방법：선취본원2009년12월-2012년12월수치적73례우원외구복핵감유사물진행항을간병독치료후출현만성중형간염적환자위연구대상，안조입원순서분위대조조38례화관찰조35례。대조조급여상규적보간、감황、영양지지등대증치료，관찰조재대조조적기출상계속급여핵감유사물은체잡위치료。비교량조치료후사망솔、HBV-DNA음전솔급량조환자치료전후곡병전안매（ALT）、혈청총담홍소（T-BILI）、백단백（ALB）、응혈매원활동도（PTA）등간공능지표변화。결과：치료24주후，관찰조사망솔2.86%，명현저우대조조적18.42%（X2=4.523，P=0.036），HBV-DNA음전솔88.57%，명현고우대조조적39.47%（X2=16.408，P=0.000）。량조환자치료전ALT、ALB、TBIL、PTA비교차이균무통계학의의（P>0.05）。경과치료후，대조조환자적ALT、TBIL균명현고우관찰조，이ALB、PTA균명현저우관찰조，차이균유통계학의의（P<0.05）。결론：대우을간병독내약도치만성중형간염적환자，항병독약물가이강저환자사망솔、제고환자HBV-DNA음전솔，촉진간장생화공능제고，치득림상상추엄응용。
Objective:To analyze the clinical effect of antiviral therapy for chronic severe hepatitis triggered by drug-fast hepatitis B virus.Method:73 patients who degenerated into chronic severe hepatitis after the treatment of oral nucleoside analogs in our hospital from December 2009 to December 2012 were selected,and they were divided into the control group for 38 cases and the observation group for 35 cases.The control group was given symptomatic treatment such as routine liver protection,anti choleplania and nutritional support,etc,the observation group was given nucleoside analogues entecavir on the basis of the control group.The mortality rate,HBV-DNA negative conversion rate were compared between the two groups;At the same time,the serum liver function indexes of alanine aminotransferase(ALT),total bilirubin(T-BILI),albumin(ALB)and prothrombin activity(PTA)were also detected and contrastive analyzed.Result:After 24 weeks’ treatment,the mortality rate of observation group was 2.86%,it was significantly lower than 18.42%of the control group(X2=4.523,P=0.036),the negative rate of HBV-DNA was 88.57%,it was higher than 39.47%of the control group(X2=16.408,P=0.000).In addition,there was no significant difference in serum ALT,ALB,TBIL and PTA levels between the two groups before treatment(P>0.05);After treatment,the ALT,TBIL in the control group were significantly higher than those in the observation group,while ALB,PTA were significantly lower than those in the observation group (P<0.05).Conclusion:For the hepatitis B virus resistance leading to chronic severe hepatitis patients,antiviral drugs can reduce the mortality of patients,improve patient HBV-DNA negative conversion rate,improve the liver function tests, worthy of clinical application.
