摘要
目的分析恩替卡韦联合糖皮质激素治疗早期乙型肝炎肝衰竭的临床效果。方法选取2018年12月至2020年12月我院收治的98例早期乙型肝炎肝衰竭患者为研究对象,根据治疗方案将其分为对照组和观察组,各49例。对照组采取恩替卡韦治疗,观察组采取恩替卡韦联合糖皮质激素治疗。比较两组患者的血液生化指标、并发症发生情况、HBV-DNA转阴率、免疫功能、临床疗效、炎性因子水平、症状改善时间、黄疸消退时间及住院时间。结果治疗后,两组患者TBIL、ALT、AST水平及HBV-DNA均较治疗前降低,PTA均较治疗前升高,且观察组优于对照组(P<0.05)。两组患者治疗期间并发症总发生率比较,差异不具有统计学意义(P>0.05)。观察组治疗1个月时HBV-DNA转阴率明显高于对照组(P<0.05)。治疗后,两组患者CD4^(+)、CD4^(+)/CD8^(+)均较治疗前升高,CD8^(+)均较治疗前降低,且观察组优于对照组(P<0.05)。观察组的治疗总有效率明显高于对照组(P<0.05)。治疗后,两组患者的MCP-1、IL-1β及HMGB1水平均明显降低,且观察组低于对照组(P<0.05)。观察组症状改善时间、黄疸消退时间及住院时间均短于对照组(P<0.05)。结论恩替卡韦联合糖皮质激素可有效改善早期乙型肝炎肝衰竭患者的血液生化指标、免疫功能和临床症状,减轻炎症反应,提高HBV-DNA转阴率和临床疗效,缩短住院时间,效果显著,值得推广。
Objective To analyze the clinical effect of entecavir combined with glucocorticoid in the treatment of early hepatitis B liver failure.Methods Ninety-eight patients with early hepatitis B liver failure treated in our hospital from December 2018 to December 2020 were selected as the research objects.According to the treatment scheme,the patients were divided into control group and observation group,with 49 cases in each group.The control group was treated with entecavir and the observation group was treated with entecavir combined with glucocorticoid.The blood biochemical indexes,occurrence of complications,HBV-DNA negative rate,immune function,clinical efficacy,inflammatory factors levels,symptom improvement time,jaundice regression time and hospitalization time were compared between the two groups.Results After treatment,the levels of TBIL,ALT,AST and HBV-DNA in the two groups were lower than those before treatment,the PTA was higher than that before treatment,and those in the observation group were better than the control group(P<0.05).There was no significant difference in the total incidence of complications during the treatment between the two groups during treatment(P>0.05).The HBV-DNA negative rate at 1 month after treatment in the observation group was significantly higher than that in the control group(P<0.05).After treatment,CD4^(+),CD4^(+)/CD8^(+)in the two groups were higher than those before treatment,CD8^(+)was lower than that before treatment,and those in the observation group were better than the control group(P<0.05).The total effective rate of treatment in the observation group was significantly higher than that in the control group(P<0.05).After treatment,the levels of MCP-1,IL-1β and HMGB1 in both groups significantly decreased,and those in the observation group were lower than the control group(P<0.05).The symptom improvement time,jaundice regression time and hospitalization time in the observation group were shorter than those in the control group(P<0.05).Conclusion Entecavir combined with
作者
刘成芳
张建霞
LIU Chengfang;ZHANG Jianxia(Traditional Chinese Medicine Hospital of Yulin,Yulin 719000,China)
出处
《临床医学研究与实践》
2022年第15期31-34,共4页
Clinical Research and Practice
