| 司慧远 靳雁斌 李晓娟 张宏伟 周平.抗病毒治疗乙型肝炎相关慢加急性肝衰竭患者的临床研究[J].,2014,14(33):6464-6466 |
| 抗病毒治疗乙型肝炎相关慢加急性肝衰竭患者的临床研究 |
| Clinical Studies on Anti-viral Therapy for the Hepatitis B Patients with Acuteon Chronic Liver Failure |
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| DOI： |
| 中文关键词: 乙型肝炎相关慢加急性肝衰竭 乙型肝炎病毒 拉米夫定 恩替卡韦 |
| 英文关键词: Hepatitis B combined with acute on chronic liver failure Hepatitis B virus Lamivudine Entecavir |
| 基金项目: |
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| 中文摘要: |
| 目的：探讨抗病毒治疗乙型肝炎相关慢加急性肝衰竭(acute on chronic liver failure,ACLF)的临床意义。方法：回顾性分析
2007 年8月~2013年8 月我院收治的乙型肝炎相关慢加急性肝衰竭的住院患者80 例，按照患者有无接受抗病毒治疗分为抗病
毒治疗组（A 组）50 例和未抗病毒治疗组（B 组）30 例，分析患者接受治疗后的近期与远期疗效、并发症及生存率。结果：①出院时
A 组好转率70%；B 组好转率33.3%。两组比较差异有统计学意义（x2=10.243，P=0.001＜0.05）。②治疗14 周后A 组乙肝病毒
DNA阴转率72%；B组阴转率30%，两组比较差异有统计学意义（x2=13.440，P=0.000＜0.05）。③A 组出现细菌感染45例，电解质
紊乱41 例，消化道出血5 例，肝性脑病10 例，肝肾综合征10 例，B组出现细菌感染30 例，电解质紊乱27 例，消化道出血6 例，肝
性脑病10 例，肝肾综合征12 例，两组比较差异无统计学意义（x2=2.755，P=0.097＞0.05）。④随访5 年，A 组存活36 例，死亡14
例，12、36 和60 个月累积生存率分别为78.5%、71.2%、71.2%，B 组存活5 例，死亡25 例，12、36 和60 个月累积生存率分别为
35.4%、27.5%、27.5%，两组比较差异有统计学意义（P＜0.05）。结论：对乙型肝炎相关慢加急性肝衰竭患者给予抗病毒治疗可明显
改善预后，提高生存率。 |
| 英文摘要: |
| Objective:To explore the clinical significance of anti-viral therapy for the hepatitis B patients with acute on chronic
liver failure.Methods:80 cases of hepatitis B patients with acute on chronic liver failure in our hospital from August 2007 to August
2013 were selected for retrospective analysis, and were divided into antiviral treatment group (group A of 50 cases) and
non-antiretroviral treatment group (group B of 30 cases). Recent and long-term efficacy, complications and survival rates and other
indicators were analyzed after treatment.Results:① The improvement rate of Group A was 70%, while 33.3% for Group B ,the
difference was statistically significant (x2 = 10.243, P= 0.001＜0.05). ② The HBV DNA negative rate of group A after 14 weeks of
treatment was 72%, while 30%for Group B, the difference was statistically significant (x2= 13.440, P=0.000＜0.05). ③ In group A, there
were 45 cases of bacterial infection, 41 cases of electrolyte disorder, 5 cases of gastrointestinal bleeding in, 10 cases of hepatic
encephalopathy, while group B had 10 cases of hepatorenal syndrome, 30 cases of bacterial infections, 27 cases of electrolyte disorder, 6
cases of gastrointestinal bleeding, 10 cases of hepatic encephalopathy, and 12 cases of hepatorenal syndrome, the difference was not
statistically significant (x2= 2.755, P= 0.097 > 0.05). ④ Follow-up of 5 years showed that 36 cases survived in group A while 14 cases
died, the cumulative survival rates at 12, 36 and 60 months were 78.5%, 71.2%, and 71.2%respectively; There were 5 cases of surviving
in group B and 25 cases of death, the cumulative survival rates at 12, 36 and 60 month was 35.4%, 27.5%, and 27.5%, the difference was
statistically significant (P<0.05).Conclusion:Anti-viral therapy can significantly improve the prognosis and survival rate in hepatitis B
patients with acute on chronic liver failure. |
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