抗病毒基础上应用强的松治疗早期乙型重型肝炎临床疗效观察-论文.pdf

《抗病毒基础上应用强的松治疗早期乙型重型肝炎临床疗效观察-论文.pdf》由会员上传分享，免费在线阅读，更多相关内容在应用文档-天天文库。

1、中国实用医刊2014年3月第41卷第5期ChineseJ·49·抗病毒基础上应用强的松治疗早期乙型重型肝炎临床疗效观察鲍素霞孙长宇周言【摘要】目的观察抗病毒基础上应用强的松治疗早期乙型重型肝炎的临床疗效。方法选择6O例早期乙型重型肝炎患者，分成治疗组3O例和对照组30例。对照组采用常规内科综合治疗和替比夫定抗病毒治疗；治疗组在对照组的基础上加用强的松30mg，晨起顿服，待胆红素下降至一半时，每周减量5mg直至停用。观察两组治疗前后血清生化指标变化、不良反应和并发症。结果治疗后治疗组总胆红素明显下降，与对照组比较差异有统计学意义(P<0．05)；治疗组不

2、适症状消失时间明显缩短，但8周后两组的转氨酶复常率、凝血酶原活动度和HBV-DNA阴转率比较差异均无统计学意义(P>0．05)。结论抗病毒基础上应用强的松能明显改善患者早期不适症状，促进黄疸的消退，阻止早期重型肝炎进一步发展，安全性较好，但不能明显提高患者转氨酶的复常率、凝血功能和HBV-DNA阴转率。【关键词】早期乙型重型肝炎；抗病毒治疗；强的松EfectsofprednisolonecombinedwitllantiviraltherapyonpatientswithearlyseverehepatitisBBAOSu-xia，SUNChang—y

3、u，ZHOUYan．DepartmentofInfectiousDiseases，theAffiliatedHospitalofZhengzhouUniversity，Zhengzhou450052，China【Abstract】OMeetiveToobservetheeffectofprednisolonecombinedwithantiviraltherapyonpatientswithearlyseverehepatitisB．MethodsSixtycasesofearlyseverehepatitisBwererandomlydividedi

4、ntotreatmentgroupandcontrolgroup(30cases)．Patientsinthecontrolgroupweregivencon—ventionalmedicaltreatmentandanti—viruswithtelbivudine，whilepatientsinthetreatmentgroupweregivenprednisolone30mginadditiontothetreatmentincontrolgroup，whentheTBILdecreasedtoonehalf，prednisolonewasredu

5、cedby5mgeveryoneweekuntilthewithdraw；Serumbiochemicalvalueschanges，advemereactionsandcomplicationsinthetwogroupswereobservedbeforeandaftertreatment．ResultsInthetreatmentgroup，theTBILwasobviouslylowerthanthatinthecontrolgroupaftertreatment，therewassignificantdifferencebetweenthet

6、wogroups(P<0．05)．Thedisappearingtimeofclinicalsymptomsintreatmentgroupwasobviouslyshortened．ButtherewerenosignificantdifferencesinthenormalizationrateofALT．PTactivitylevelandthenegativeconversionrateofset-amHBV-DNAat8weekslater(P>0．05)．ConclusionsPrednisolonecombinedwithantivira

7、ltherapyissafeandeconomicalandhasaremarkableeffectonimprovingtheclinicalsymptomsofear-lyseverehepatitisB，decreasingthelevelofserumTBIL．Soitpreventthefurtherdevelopment，butcannotsignificantlyimprovethenormalizationrateofALT．coagulationfunctionandthenegativeconversionrateofHBV—DNA

8、．【Keywords】EarlyseverehepatitisB；Antiviralthera