【摘要】 目的用霉酚酸酯(MMF)治疗进展迅速的慢性重度乙型肝炎以阻断重型肝炎的发生。方法进展迅速的慢性重度乙型肝炎患者60例随机分为治疗组(34例)和对照组(26例)。对照组接受还原型谷胱甘肽、前列腺素E1及新鲜血浆、白蛋白等支持治疗,治疗组在对照组治疗方案的基础上加用MMF治疗。结果MMF治疗组治疗好转率为88.2%(30/34),明显高于对照组的65.4%(17/26,×2=4.53,P<0.05)。治疗组平均住院(19.3±6.3)d,对照组为(27.3±5.8)d,二者相比有显著性差异(t=4.98,P<0.05)。治疗组有5.9%(2/34)发展为慢性重型肝炎,对照组重型肝炎发生率为26.9%(7/26),二者相比有显著性差异(χ2=5.12,P<0.05)。未观察到MMF有明显诱发继发感染、消化道出血及外周血白细胞减少等毒副反应。结论MMF能安全地用于治疗进展迅速的慢性重度乙型肝炎,能有效地阻止其向慢性重型肝炎发展。更多还原

【Abstract】 Objective: To prevent chronic severe hepatitis occurrence, patients with exacerbating chronic hepatitis B of severe degree were treated with Mycophenolate mofetil(MMF). Methods: 60 patients were randomized into conventional treatment group (26 cases) and MMF treatment group (34 cases). For the patients in conventional group, glutathione injection, PGE1 injection and Human Serum Albumin or Human fresh plasma were administrated daily, for the patients in MMF group, 1.0 g/d MMF were administrated orally for 30 days plus with the same treatment of conventional group. Results: The rate of convalescence in MMF treatment group is 88.2%, which was significantly higher than which of conventional group(65.4%, χ2=4.53,P<0.05). The average hospitalization duration in MMF treatment group was significantly lower than which in conventional group(19.3±6.3 days vs 27.3±5.8 days, t=4.98, P<0.05). The rate of deteriorating to chronic severe hepatitis in MMF group was 5.9%, which was significantly lower than which in conventional group (26.9%, χ2=5.12, P<0.05). No severe adverse reaction such as complication of infections, gastrointestinal bleeding and leucopenia were found in the trial. Conclusions: MMF was effective and safe for treatment of the patients with exacerbating chronic hepatitis B of severe degree.更多还原