摘要
目的:观察乙酰半胱氨酸(NAC)注射液治疗慢性重型乙型肝炎的疗效。方法:将48例慢性重型乙型肝炎患者(慢加急性肝衰竭8例,慢加亚急性肝衰竭30例,慢性肝衰竭10例)随机分为对照组24例,治疗组24例。对照组患者采用常规综合治疗措施,治疗组患者在此基础上,给予NAC注射液8g/d,静脉滴注,疗程45天。在治疗0、15、30、45天时观察患者临床症状、肝功能、凝血酶原活动度(PTA)的变化,以及药物不良反应。结果:对照组脱落5例,治疗组脱落6例。两组患者在治疗后血清总胆红素(TBil)水平及PTA均得到明显改善;治疗组患者治疗后血清TBil的下降及PTA的提升较对照组好,治疗组患者TBil下降率及PTA提升率在45天时与对照组比较,差异有显著性意义(P<0.05)。治疗组的总有效率明显高于对照组(P<0.05)。NAC不良反应主要为恶心、呕吐、皮疹等,无严重不良反应。结论:NAC能明显降低肝衰竭患者血清TBil水平,改善PTA,治疗过程中患者耐受性较好,值得临床上推广应用。
Objective： To observe the therapeutic effects of N-acetylcysteine （NAC） injection on the patients with chronic severe hepatitis B （CSHB） . Methods： Forty and eight patients with CSHB （total bilirubin, TBil 〉 171μmol/L, 20% 〈PTA 〈 40% ） were selected and divided randomly into two groups; treatment group and control group. All the patients received routine combined modality therapy, while 24 patients in the treatment group, based on the routine therapy, received additional treating with NAC injection by a daily dose of 8g for 45 days. The changes of patient＇s clinical symptoms, liver functions, prothrombin activity （PTA） and adverse drug reaction were observed at 0, 15, 30 and 45 day during the period of treatment respectively. Results： Ten and one cases of the 48 patients dropped out （5 cases in control group, 6 cases in treatment group） . The levels of TBil and PTA were improved obviously after treating in the patients of both groups. The decrease of TBil and increase of PTA in the treatment group were better than that of control group, hut the differences between two groups had no statistical significance （P 〉 0. 05 ） . The decrease rate of TBil and increase rate of PTA were significantly higher than that of control group at 45 day during the period of treating （ P 〈 0.05 ） . The total effective rate was 70. 8% in the treatment group and 41.7% in the control group （P 〈 0.05 ） . The main adverse reaction of NAC was nausea, vomiting and rash in few patients. Conclusion： It is suggested that NAC could decrease the levels of serum TBil and increase the PTA in the patients with hepatic failure, and NAC has no severe adverse effects during administration.
出处
《中西医结合肝病杂志》
CAS
2009年第3期140-142,共3页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
