CAJ | 학술논문

目的探索慢加急性肝衰竭严重性评分系统不同评分范围的HBeAg阴性慢加急性肝衰竭在内科综合治疗基础上加用恩替卡韦治疗时机与疗效的关系.方法观察并比较108例不同肝衰竭严重性评分范围HBeAg阴性慢加急性肝衰竭加用恩替卡韦抗HBV开始治疗时、恢复期或临终前的肝衰竭严重性指标、HBV DNA载量、疗程和死亡率.结果肝衰竭严重性评分高评分组(≥12分)19例,治疗前后肝衰竭严重性评分及HBV DNA载量差异均无统计学意义,死亡率为18/19.中上评分组(8～11分)30例,治疗前后肝衰竭严重性评分差异无统计学意义,治疗前后HBV DNA载量差异有统计学意义,死亡率66.67％(20/30).中下评分组(5～7分)36例,治疗前后肝衰竭严重性评分差异无统计学意义,治疗前后HBV DNA载量差异有统计学意义,死亡率30.56％(11/36).低评分组(≤4分)23例,治疗前肝衰竭严重性评分较缓解期肝衰竭严重性评分明显下降,差异有统计学意义,治疗前后HBV DNA载量差异有统计学意义,死亡率8.70％ (2/23).结论新颖的肝衰竭评分系统能较清晰地分辨恩替卡韦治疗HBeAg阴性慢加急性肝衰竭时机与疗效的关系.
목적 탐색만가급성간쇠갈엄중성평분계통불동평분범위적HBeAg음성만가급성간쇠갈재내과종합치료기출상가용은체잡위치료시궤여료효적관계.방법 관찰병비교108례불동간쇠갈엄중성평분범위HBeAg음성만가급성간쇠갈가용은체잡위항HBV개시치료시、회복기혹림종전적간쇠갈엄중성지표、HBV DNA재량、료정화사망솔.결과 간쇠갈엄중성평분고평분조(≥12분)19례,치료전후간쇠갈엄중성평분급HBV DNA재량차이균무통계학의의,사망솔위18/19.중상평분조(8～11분)30례,치료전후간쇠갈엄중성평분차이무통계학의의,치료전후HBV DNA재량차이유통계학의의,사망솔66.67％(20/30).중하평분조(5～7분)36례,치료전후간쇠갈엄중성평분차이무통계학의의,치료전후HBV DNA재량차이유통계학의의,사망솔30.56％(11/36).저평분조(≤4분)23례,치료전간쇠갈엄중성평분교완해기간쇠갈엄중성평분명현하강,차이유통계학의의,치료전후HBV DNA재량차이유통계학의의,사망솔8.70％ (2/23).결론 신영적간쇠갈평분계통능교청석지분변은체잡위치료HBeAg음성만가급성간쇠갈시궤여료효적관계.
Objective To explore relations between the opportunities and effects of internal general treatment added Entecavir on acute-on-chronic liver failure (ACLF) of HBeAg-negative chronic hepatitis B in different score ranges of acute-on-chronic liver failure severity.Methods A total of 108 ACLF of HBeAgnegative chronic hepatitis B patients with different ACLF severity score were treated with internal general treatment added Entecavir.The liver failure severity scores,HBV-DNA loads during the initiation of therapy,recovery phase and in deathbed phase,courses of Entecavir administration and mortalities were studied.Results For 19 patients with high ACLF score (≥ 12),the difference in ACLF score between pre and post-treatment was not significant.The difference in HBV-DNA load between pre and post-treatment was not significant and the mortality was 18/19.For 30 patients with higher intermediate ACLF score (8-11),the difference in ACLF score between pre and post-treatment was not significant.The difference in HBV-DNA load between pre and post-treatment was significant,and the mortality was 66.67％ (20/30).For 36 patients with lower intermediate ACLF score (5-7),the difference in ACLF score between pre and posttreatment was not significant.The difference in HBV-DNA load between pre and post-treatment was significant,and the mortality was 30.56％ (11/36).For 23 patients with low ACLF score (≤4),the difference in ACLF score between pre and post-treatment was significant.The difference in HBV-DNA load between pre and post-treatment was significant,and the mortality was 8.70％ (2/23).Conclusions A novel acute-on-chronic liver failure scoring system can syllabify differentiate the relations between the opportunities and efficacies on the Entecavir treatment for HBeAg-negative ACLF.