摘要
目的探讨短程糖皮质激素(GC)联合核苷类似物治疗重型肝炎前期及早期患者的临床效果。方法回顾性分析2013年1月至2020年12月宜春学院第二附属医院收治的60例重型肝炎前期及早期患者的临床资料,根据不同药物治疗方法分为试验组(29例)和对照组(31例)。对照组采用核苷类似物抗病毒及常规内科综合治疗,试验组在对照组基础上联合GC短程治疗5~7 d。比较两组患者的临床疗效、肝功能、凝血功能指标及不良反应发生情况。结果两组的临床治疗效果比较,差异无统计学意义(P>0.05)。试验组治疗后的总胆红素(TBil)、谷丙转氨酶(ALT)水平低于对照组,差异有统计学意义(P<0.05);两组治疗后的白蛋白(ALB)比较,差异无统计学意义(P>0.05)。试验组治疗后的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)短于对照组,纤维蛋白原(FIB)低于对照组,凝血酶原活动度(PTA)高于对照组,差异有统计学意义(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论短程GC联合核苷类似物治疗重型肝炎前期及早期患者比单独使用核苷类似物效果更好,能有效改善患者肝功能以及凝血功能障碍,且安全性良好。
Objective To investigate the clinical effect of short-term glucocorticoid(GC)combined with nucleoside analogues in the treatment of patients with severe hepatitis.Methods The clinical data of 60 patients with severe hepatitis who were admitted to the Second Affiliated Hospital of Yichun University from January 2013 to December 2020 were retrospectively analyzed.According to different drug treatment methods,they were divided into experimental group(29 cases)and control group(31 cases).The control group was treated with antiviral nucleoside analogues and conventional medical treatment,and the experimental group was treated with GC for 5-7 days.The clinical efficacy,liver function,coagulation function and the occurrence of adverse reactions were compared between the two groups.Results There was no significant difference in clinical treatment effect between the two groups(P>0.05).The levels of total bilirubin(TBil)and alanine aminotransferase(ALT)in experimental group were lower than those in control group,the differences were statistically significant(P<0.05).There was no significant difference in albumin(ALB)between the two groups after treatment(P>0.05).After treatment,prothrombin time(PT)and activated partial thrombin time(APTT)in experimental group were shorter than those in control group,while fibrinogen(FIB)and prothrombin activity(PTA)in experimental group were lower than those in control group,the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Compared with nucleoside analogues alone,curative effect of short-term GC combined with nucleoside analogues is more significant on patients with early severe hepatitis,which can effectively improve liver function and coagulation dysfunction,with good safety.
作者
彭芳
涂龙
廖群
PENG Fang;TU Long;LIAO Qun(Department of Infectious Diseases,Second Affiliated Hospital of Yichun University,Jiangxi Province,Yichun336000,China)
出处
《中国当代医药》
CAS
2022年第10期46-49,共4页
China Modern Medicine
基金
江西省宜春市科技计划项目(JXYC2021KSA044)。
