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目的讨抗病毒治疗对不同分期的乙型肝炎相关慢加急性肝衰竭患者短期预后的影响。方法选取118例乙型肝炎相关慢加急性肝衰竭患者,其中早期患者64例、中期患者42例、晚期患者12例,各期患者分为对照组和试验组,试验组在常规内科治疗和人工肝支持基础上加用抗病毒药物治疗(拉米夫定、恩替卡韦),比较各期患者临床特征、生存率及抗病毒治疗12周疗效差异。结果观察3个月,乙型肝炎相关慢加急性肝衰竭早、中、晚期患者的生存率明显不同(P<0.01)。随着病情的加重,生存率明显下降。不同分期分析,晚期患者对照组及试验组生存率无明显差异(P>0.05),而早中期患者试验组生存率明显高于对照组(P<0.05)。结论抗病毒治疗可提高早中期乙型肝炎相关慢加急性肝衰竭患者的生存率,而对于晚期患者抗病毒治疗对生存率无影响。
Objective To discuss the impact of virus treatment on the short-term prognosis of patients with different stages of chronic hepatitis B and acute liver failure. Methods A total of 118 patients with chronic hepatitis B-related acute and acute liver failure were selected. Among them, 64 cases were early stage, 42 cases were middle stage and 12 cases were late stage. The patients were divided into control group and trial group. Antiviral therapy (lamivudine, entecavir) was added on the basis of liver support. The clinical characteristics, survival rate and anti-virus treatment efficacy at 12 weeks were compared. Results The survival rates of patients with early, middle and late stages of hepatitis B-related chronic and acute liver failure were significantly different at 3 months (P <0.01). As the disease aggravated, the survival rate decreased significantly. There were no significant differences in the survival rates between the control group and the experimental group (P> 0.05). However, the survival rate of the experimental group was significantly higher than that of the control group (P <0.05). Conclusion Antiviral therapy can improve the survival rate of patients with chronic hepatitis B and acute liver failure in the early and middle stages, but has no effect on the survival rate in patients with advanced stage of antiviral therapy.