CAJ | 학술논문

目的探讨糖皮质激素治疗早期慢性重型乙型肝炎的疗效和安全性.方法63例早期慢性重型乙型肝炎患者入组临床对照试验;对照组36例接受保肝、支持和抗病毒治疗,治疗组27例加用激素治疗;比较4周后两组患者的谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBil)、胆碱酯酶(CHE)、胆固醇(CHO)、凝血酶原时间(PT)和并发症情况.结果两组患者在早期均经历一段黄疸上升期,ALT、AST、CHE均显著下降;治疗4周时联合组PT较对照组显著改善,CHO显著高于对照组;联合治疗组低钾血症的发生率高于对照组.结论激素治疗早期慢性重型肝炎安全、有效,缩短患者住院时间,在改善凝血功能方面更具优势;使用中应注意血钾的监测.
목적탐토당피질격소치료조기만성중형을형간염적료효화안전성.방법63례조기만성중형을형간염환자입조림상대조시험;대조조36례접수보간、지지화항병독치료,치료조27례가용격소치료;비교4주후량조환자적곡병전안매(ALT)、곡초전안매(AST)、총담홍소(TBil)、담감지매(CHE)、담고순(CHO)、응혈매원시간(PT)화병발증정황.결과량조환자재조기균경력일단황달상승기,ALT、AST、CHE균현저하강;치료4주시연합조PT교대조조현저개선,CHO현저고우대조조;연합치료조저갑혈증적발생솔고우대조조.결론격소치료조기만성중형간염안전、유효,축단환자주원시간,재개선응혈공능방면경구우세;사용중응주의혈갑적감측.
Objective To evaluate the efficacy and safety of glucocorticoids combined with antiviral therapy for treating early chronic severe hepatitis B. Methods A controled clinical trial was performed for 4 weeks.63 patients who were diagnosed as early chronic severe hepatitis, were divided into treated group(27 cases) and control group (36 cases).Patients in the control group were given conventional treatment and nucleoside analogues, while the treated group were added glucocorticoids.ALT, AST, TBil, CHE, CHO and PT of the two groups were compared before and after therapy.The side effect and complication were monitored. Results At the early stage, there was a jaundice rise period in both groups,while the ALT, AST, CHE declined obviously(P<0.05) . Compared with the control group, PT and CHO were improved significantly (P<0.05) in the treated group. The incidence of hypokalemia in the treated group was higher than that in the control group (P<0.05). Conclusion Glucocorticoids combined with antiviral therapy is effective and safe for treating early chronic severe hepatitis B, reduce the average length of stay , and can improve the coagulation function obviously.It also suggests us to pay attention to monitor the serum potassium.