摘要
目的:探讨前列地尔联合恩替卡韦治疗乙型肝炎肝硬化失代偿期患者并发难治性腹水的临床疗效。方法:选取乙型肝炎肝硬化失代偿期患者并发难治性腹水84例,随机分为对照组和病例组,每组各42例。对照组给予恩替卡韦治疗,病例组给予恩替卡韦和前列地尔治疗。观察两组患者的临床疗效、肝肾功能、血清病毒学及影像学指标变化。结果:病例组的总有效率为95.24%,高于对照组的73.81%,差异有统计学意义(P<0.05)。与同组治疗前比较,治疗后两组患者ALT、AST、TBIL、BUN、Cr、门静脉内径、脾静脉内径、脾脏厚度显著降低,ALB、双侧肾动脉内径、肾血流量显著升高,差异均有统计学意义(P<0.05)。治疗后,病例组与对照组比较,ALT、AST、TBIL、PTA、BUN、Cr、门静脉内径、脾静脉内径、脾脏厚度显著降低,ALB、双侧肾动脉内径、肾血流量显著升高,差异均有统计学意义(P<0.05)。病例组与对照组比较,HBV DNA转阴率、HBeAg转阴率和HBsAg转阴率明显升高,差异有统计学意义(P<0.05)。结论:前列地尔联合恩替卡韦治疗乙型肝炎肝硬化失代偿期患者并发难治性腹水临床疗效显著,可以改善微循环、肾脏血流动力学障碍,具有一定的临床推广应用价值。
Objective:To investigate the clinical efficacy of alprostadil combined with Entecavir in the treatment of patients with hepatitis B cirrhosis complicated with refractory ascites.Method:A total of 84 patients with decompensated hepatitis B cirrhosis complicated with refractory ascites were selected.The patients were randomly divided into control group and case group,42 cases in each group.The control group was treated with Entecavir,while the case group was treated with Entecavir and Prostaglandin.The changes of clinical efficacy,liver function,renal hemodynamics,virology and imaging were observed before and after treatment in the two groups.Result:The total effective rate of the case group was 95.24%,which was higher than 73.81% of the control group,the difference was statistically significant(P<0.05).Compared with the same group before treatment,the ALT,AST,TBIL,BUN,Cr,the diameter of portal vein,splenic vein and spleen thickness in the two groups decreased significantly after treatment,while the diameter of ALB,bilateral renal artery and renal blood flow increased significantly,the differences were statistically significant(P<0.05).After treatment,compared with the control group,ALT,AST,TBIL,PTA,BUN,Cr,portal vein diameter,splenic vein diameter and spleen thickness decreased significantly,while ALB,bilateral renal artery diameter and renal blood flow increased significantly,the differences were statistically significant(P<0.05).Compared with the control group,the negative rates of HBV DNA,HBeAg and HBsAg were significantly higher in the case group,the differences were statistically significant(P<0.05).Conclusion:Alprostadil combined with Entecavir in the treatment of patients with decompensated hepatitis B cirrhosis complicated with refractory ascites has significant clinical efficacy,it can improve microcirculation,renal hemodynamic disorders,has a certain clinical application value.
作者
李志英
李宏韬
雷霞
方正亚
LI Zhiying;LI Hongtao;LEI Xia;FANG Zhengya(Affiliated Hospital of Jiujiang University,Jiujiang 332000,China)
出处
《中国医学创新》
CAS
2019年第28期7-10,共4页
Medical Innovation of China
基金
中国肝炎防治基金会资助项目(TQGB20170015)
