摘要
目的:观察小剂量强的松在慢性重型乙型肝炎中的应用效果。方法:将40例慢性重型乙型肝炎患者分为治疗组(20例)和对照组(20例),2组均给予常规保肝、抗病毒及对症支持治疗。在此基础上治疗组给予强的松,对照组给予安慰剂,初始剂量20mg/d,后每2周减量5mg,直至停药。观察治疗前及治疗后第2、4、6、8周血清总胆红素、谷丙转氨酶、凝血酶原活动度、乙肝病毒载量及患者不适症状缓解时间。结果:与对照组相比,治疗组总胆红素(F组间=52.743,F时间=1110.318,P<0.001)、谷丙转氨酶(F组间=26.898,F时间=927.736,P<0.001)下降,治疗组的不适症状消失时间缩短,转氨酶复常率提高(χ2=15.000,P<0.001),但8周后2组间HBV-DNA及凝血酶原活动度变化差异无统计学意义(P>0.05)。结论:小剂量强的松的应用可改善慢性重型乙型肝炎患者的早期不适症状,促进黄疸的消退,加速转氨酶的复常,安全性较好,花费少,但不能明显改善患者的凝血功能。
Aim：To study the clinical efficacy of low-dose prednisone in treatment of chronic severe Hepatitis B.Methods：The enrolled patients accepting low-dose prednisone treatment were allocated into two groups.Patients in the control group received protecting liver,antiviral therapy,and other symptomatic supportive treatment as well as the placebos.Patients in the treatment group received prednisone 20 mg on the basis of control group,then reduce the dose by 5 mg every two weeks,until be stopped.The changes of clinical symptoms of the 2 groups were observed.Before and at the second,fourth,sixth,and eighth week after the therapy,the aminotransferase（ALT）,the serum total bilirubin（TBil）,and the prothrombin activities（PTA） were recorded.Results：After the treatment,compared with the control group,TBil（Fgroup=52.743,Ftime=1 110.318,P0.001） and ALT（Fgroup=26.898,Ftime=927.736,P0.001） descended significantly,the clinical symptoms improved,and the normalization rate of ALT increased in the treatment group（χ2=15.000,P0.001）.But it was not helpful to change the HBV-DNA and PTA level（P0.05）.Conclusion：Low-dose prednisone is safe and economical,and has a remarkable effect on improving the clinical symptoms of the chronic severe hepatitis B patients with early symptoms,decreasing the level of serum TBil and recovery of ALT,but could not significantly improve patients＇ blood clotting.
出处
《郑州大学学报（医学版）》
CAS
北大核心
2012年第6期827-829,共3页
Journal of Zhengzhou University(Medical Sciences)
基金
国际交流与合作基金资助项目IHECC-005
