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[目的]探讨免疫调节治疗在HBV相关慢加急性肝衰竭早期患者中的疗效。[方法]将80例HBV相关慢加急性肝衰竭早期患者随机分为对照组(40例)和实验组(40例),对照组患者给予常规内科治疗,实验组患者给予在常规治疗的基础上加用地塞米松、静注免疫球蛋白的治疗方案,2组患者常规治疗疗程均为4周。2组患者分别于治疗前及治疗1周、4周后检测总胆红素、白蛋白及凝血酶原活动度,并于治疗4w后进行疗效判断。[结果]治疗4周后,实验组患者总胆红素较对照组明显降低,实验组患者白蛋白及凝血酶原活动度较对照组升高,差异均具有统计学意义(P<0.05);实验组总有效率显著高于对照组(P<0.05)。[结论]在常规内科治疗基础上,给予地塞米松联合静注免疫球蛋白治疗HBV相关慢加急性肝衰竭早期患者,可以有效改善患者肝功能,显著提高患者的存活率,降低其病死率。
[Objective] To investigate the effect of immunomodulatory therapy in patients with early-stage HBV-related chronic and acute liver failure. [Methods] Eighty patients with early HBV-related acute and chronic liver failure were randomly divided into control group (40 cases) and experimental group (40 cases). Patients in control group were given conventional medical treatment. Patients in experimental group were given routine treatment Plus dexamethasone, intravenous immunoglobulin treatment regimen, 2 groups of patients with conventional treatment are 4 weeks. Two groups of patients before and after treatment for 1 week, 4 weeks after the detection of total bilirubin, albumin and prothrombin activity, and 4w after treatment efficacy judgment. [Results] Total bilirubin in the experimental group was significantly lower than that in the control group after 4 weeks of treatment. The activities of albumin and prothrombin in the experimental group were significantly higher than those in the control group (P <0.05). The total effective rate in experimental group was significantly higher than that in control group (P <0.05). [Conclusion] Dexamethasone combined with intravenous immunoglobulin can effectively improve the liver function, significantly improve the survival rate and reduce the mortality of patients with HBV-related early-onset acute liver failure, based on routine medical treatment.