拉米夫定联合血浆置换治疗乙型肝炎相关慢加急性肝衰竭的疗效分析

胡启江，江应安.拉米夫定联合血浆置换治疗乙型肝炎相关慢加急性肝衰竭的疗效分析[J].临床肝胆病杂志, 2013, 29(2). 107-109

肝功能衰竭 血浆置换 拉米夫定 肝炎,乙型

胡启江，江应安

(武汉大学,武汉,430072)

2013年

107-109

知网,万方

目的 观察拉米夫定联合血浆置换治疗乙型肝炎相关慢加急性肝衰竭的临床疗效.方法 选择乙型肝炎相关慢加急性肝衰竭患者92例,随机分为2组,治疗组47例,对照组45例.2组采用类似的内科基础治疗,均给予拉米夫定100 mg/d,治疗组加血浆置换,采用终末期肝病评分模型(MELD),比较2组患者在MELD＜ 30、30≤MELD＜ 40和MELD≥40 3个亚组中的存活率的差异.结果 治疗组总存活率为63.82％,而对照组总存活率为44.44％ (x2 =4.31,P＜0.05)；在30≤ MELD＜ 40亚组中治疗组存活率为71.42％,而对照组存活率为38.10％(x2=4.71,P＜0.05),在MELD＜ 30和MELD≥40亚组中,治疗组存活率与对照组分别相比,差异无统计学意义(P＞0.05).结论 30≤MELD＜ 40的乙型肝炎相关慢加急性肝衰竭患者采用拉米夫定联合血浆置换治疗能提高患者存活率. ObjectiveToevaluatetheadversereactionsinducedbyadefovirdipivoail(ADV)treatmentinpatientswithchronichepatitisB(CHB)。MethodsOne一hundred一and一twentypatientsdiagnosedwithCHBbetweenDecember2007andP'ebruar-v2012andtreatedmith(1117PasingleconventionaldosageofADZ[10mgoncedaily(OD);groupA，n=85]oranothertypeofantiviraldrug(100mgODlami".-u-or0.5mgODentecavir;groupB，n=35)wereanalyzedpatients.Aftertreatmentinitiation，routinetestsofbloodarmseVer飞fourweeksfor12weeks.Thereafter.routinetestsofbloodPre一treatmentroutineurinalysisandrenalfunctiontestswerenormalforall，liverfunctionmarkers,andrenalfunctionmarkerswerecarriedonceout，urine,liverfunctionmarkers，renalfunctionmarkers，serumphosphorus.SPPIlm(;rPa}.111P1i11}aSPandserumamylasec,elecarriedoutonceevery12weeks.Results\dine(10.59%)ofthepatientsingroupAshowedabnormalurinetestresults，includingpositivityforurineproteinvszsparametersweretransientforfive(5.88r7r)andsustainedfortheormicroscopichematuria.Oftheseninecases，theabnormalurinal-otherfour(4.71%)。Incontrast，onlyonepatient(2.86%)nagroupBshowedtransientabnormalhive(5.88%)patientsingroupAHow-ever,thedifferencebetweenthetwogroupswasnotstatisticallysignificant(P>0.05、one(2.86%)patientingroupBshowedtransientlyincreasedbloodureanitrogen(BLl})，butthedifferencedidnotreachstatisticallionIngeneral，ADVtherapy,atasignificance(P>0.OS)Vootheradversereactionswereobservedineitheroftheconventionaldose，isasafetreatmentmodalityforchronichepatitisBpatients.Somesustained，thetherapeuticregimenshouldbemodifiedaccordingly. groups.ConClu- patientsmayde- yelopabnormalurineparameters;ifthisabnormalityis。。