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目的探讨胸腺肽α1对乙型肝炎肝硬化并发自发性细菌性腹膜炎(SBP)的临床疗效。方法选取2011年2月—2013年10月在西安市唐都医院治疗的乙型肝炎肝硬化并发SBP患者96例,随机分为治疗组(48例)和对照组(48例)。对照组给予抗感染治疗,口服头孢曲松钠片,0.25 g/次,4次/d;另给予清蛋白、血浆等对症支持治疗,除此之外不使用其他免疫调解药物和抗病毒药物。治疗组在对照组基础上sc注射用胸腺肽α1 1.6 mg/次,隔天1次。两组均连续治疗3周。结果治疗后,两组血白细胞、血中性粒细胞比例、腹水白细胞均较治疗前明显下降,同组治疗前后差异有统计学意义(P<0.05);治疗后,治疗组这3项观察指标均明显低于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、总蛋白(TP)均较治疗前明显下降,治疗前后差异有统计学意义(P<0.05);治疗后,治疗组这些观察指标均明显低于对照组,两组比较差异有统计学意义(P<0.05)。治疗组治疗后体温恢复时间、腹水消失时间、腹水常规正常时间、腹水培养阴性时间、腹部压痛消失时间均低于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,治疗组和对照组的总有效率分别为87.5%、66.7%,两组比较差异有统计学意义(P<0.05)。治疗后,治疗组CD3+、CD4+、CD4+/CD8+和NK细胞比例均较治疗前明显升高,治疗前后差异有统计学意义(P<0.05);治疗后,治疗组这些观察指标均明显高于对照组,两组比较差异有统计学意义(P<0.05)。结论胸腺肽α1对乙型肝炎肝硬化并发SBP有较好的临床疗效,可以调节患者的机体免疫功能,促进肝功能恢复,具有良好的临床推广价值。
Objective To investigate the clinical effect of thymosin α1 on spontaneous bacterial peritonitis (SBP) in patients with hepatitis B cirrhosis. Methods 96 cases of hepatitis B cirrhosis complicated with SBP treated in Tangdu Hospital of Xi’an from February 2011 to October 2013 were randomly divided into treatment group (48 cases) and control group (48 cases). The control group was given anti-infective therapy. Oral ceftriaxone sodium tablets, 0.25 g / time, 4 times / d; other given albumin, plasma and other symptomatic and supportive treatment, in addition do not use other immunomodulatory drugs and antiviral drugs. The treatment group on the basis of the control group, thymosin α1 1.6 mg injection, once every other day. Two groups were treated for 3 weeks. Results After treatment, the ratio of leucocyte, blood neutrophil, ascites leukocyte in both groups decreased significantly compared with that before treatment, the difference was statistically significant before and after treatment (P <0.05); after treatment, the three observation indexes Were significantly lower than the control group, the difference between the two groups was statistically significant (P <0.05). After treatment, the levels of ALT, TB, TBIL and TP in the two groups were significantly lower than those before treatment, and there was significant difference between before and after treatment Statistical significance (P <0.05); After treatment, the treatment group of these indicators were significantly lower than the control group, the difference between the two groups was statistically significant (P <0.05). After treatment, the body temperature recovery time, ascites disappearance time, routine ascites routine time, ascites culture negative time, abdominal tenderness disappear time were lower than the control group, the difference between the two groups was statistically significant (P <0.05). After treatment, the total effective rate of the treatment group and the control group was 87.5% and 66.7%, respectively, with significant difference between the two groups (P <0.05). After treatment, the proportion of CD3 +, CD4 +, CD4 + / CD8 + and NK cells in treatment group were significantly higher than those before treatment, and the difference was statistically significant before and after treatment (P <0.05); After treatment, the observation group was significantly higher than the control group Group, the difference between the two groups was statistically significant (P <0.05). Conclusion Thymosin α1 has a good clinical effect on hepatitis B cirrhosis complicated with SBP, which can regulate the immune function of patients and promote the recovery of liver function, and has a good clinical value of popularization.