论文部分内容阅读
目的探讨抗病毒治疗对慢性乙型肝炎肝衰竭的1年疗效。方法收集慢性乙型肝炎肝衰竭病例,选取54例为抗病毒治疗组,选取历史病例67例为对照组。抗病毒治疗组在常规内科治疗的基础上加用抗病毒药物治疗(拉米夫定、恩替卡韦、替比夫定),对照组仅使用内科常规治疗。分析两组患者在不同时间点病死率、HBV DNA水平、INR、MELD评分及肝功能结果。结果治疗1个月后,两组死亡率差异无统计学意义(P>0.05)。治疗3个月后,抗病毒治疗组死亡15例(27.8%),显著低于对照组(32例,47.8%),差异有统计学意义(P<0.05)。治疗1年后抗病毒治疗组死亡15例(27.8%),显著低于对照组(37例,61.7%),差异有统计学意义(P<0.05)。治疗1个月后,两组患者ALT、AST、TBIL、INR水平及MELD评分差异无统计学意义(P>0.05);抗病毒治疗组HBV DNA水平显著低于对照组,差异有统计学意义(P<0.05)。治疗3个月及1年后抗病毒治疗组ALT、AST、TBIL、INR、HBV DNA水平及MELD评分显著低于对照组,差异有统计学意义(P<0.05)。结论抗病毒治疗可降低慢性乙型肝炎肝衰竭患者的死亡率,加快肝功能好转,抑制病毒复制,具有肯定的治疗作用。病情好转后维持抗病毒治疗,可以明显改善慢性乙型肝炎肝衰竭患者的长期预后。
Objective To investigate the effect of antiviral therapy on chronic hepatitis B liver failure in one year. Methods Chronic hepatitis B liver failure cases were collected, 54 cases were selected as antiviral therapy group, 67 cases of history were selected as the control group. The antiviral treatment group was treated with antiviral drugs (lamivudine, entecavir, telbivudine) on the basis of conventional medical treatment, and the control group was treated with routine medical treatment. The mortality, HBV DNA level, INR, MELD score and liver function of two groups were analyzed at different time points. Results After 1 month of treatment, there was no significant difference in mortality between the two groups (P> 0.05). After 3 months of treatment, 15 cases (27.8%) died in the antiviral treatment group, which was significantly lower than that in the control group (32 cases, 47.8%). The difference was statistically significant (P <0.05). One year after treatment, 15 patients (27.8%) died in the antiviral treatment group, which was significantly lower than that in the control group (37 cases, 61.7%). The difference was statistically significant (P <0.05). There was no significant difference in ALT, AST, TBIL, INR levels and MELD scores after 1 month of treatment (P> 0.05). HBV DNA level in antiviral therapy group was significantly lower than that in control group (the difference was statistically significant P <0.05). The levels of ALT, AST, TBIL, INR, HBV DNA and MELD in the antiviral therapy group at 3 months and 1 year after treatment were significantly lower than those in the control group (P <0.05). Conclusion Antiviral therapy can reduce mortality in patients with chronic hepatitis B and improve liver function, inhibit viral replication, and has a positive therapeutic effect. Maintenance of antiviral therapy after the condition improves, can significantly improve the long-term prognosis of patients with chronic hepatitis B liver failure.