【摘要】 目的:探讨短程使用糖皮质激素对乙型肝炎病毒(HBV)相关的早期慢性肝衰竭及急性肝衰竭的疗效。方法:选择58例住院患者,分为对照组(n=29)及治疗组(n=29),对照组采用恩替卡韦联合使用抗炎保肝等常规治疗,治疗组在对照组的治疗基础上短程使用注射用甲泼尼龙0.5～1 mg/(kg·d)治疗5 d。观察两组患者干预前后的血清总胆红素(TBIL)、ALT、AST、PT、4周生存率、合并症及不良反应发生率等指标。结果:治疗组患者经治疗后各时间点的血清ALT、AST、TBIL、PT均低于对照组,差异有统计学意义(P<0.05)。第3天,治疗组的血清ALT、AST、TBIL下降幅度大于对照组,差异有统计学意义(P<0.05)。短程使用糖皮质激素不增加药物不良反应。治疗组的4周生存率优于对照组,差异有统计学意义(P<0.05)。结论:在HBV相关慢加急性肝衰竭早期短程使用糖皮质激素有助于改善患者预后,提高4周生存率。更多还原

【Abstract】 Objective To investigate the effect of short term glucocorticoidin the treatment of patients inearly stageof HBV related acute-on-chronic liver failure.Method Fifity-eight patients with early hepatitis B related liver failure were included and divided into two groups,control group(n=29) and treatment group(n=29).The control group was treated with entecavir and anti-inflammatory and hepatoprotective drugs.The treatment group received intravenous methylprednisolone 0.5～1 mg/(kg·d) for five days on the basis of Control group.The treatment effect of HBV related acute-on-chronic liver failure,serum TBIL,AST and ALT,prothrombin time,survival rate within 4 weeks,incidence of adverse reactions,before and after intervention were compared between two groups.Results After treatment,the levels of ALT,AST,TBIL and PT of treatment groups were significantly lower than control groups(P<0.05).The serum concentrations of TBIL,ALT and AST in treatment group decreased significantly,compared with the control groupat 3 rd day(P<0.05).Short-term use of glucocorticoids not increase adverse-drug-reactions.The 4-week survival rate of the case group was better than that of the control group(P<0.05).Conclusion The short-term glucocorticoid treatment can improve 4-week survival rate of patients in early-stage HBV-relatedacute-on-chronic liver failure.更多还原