摘要
目的探讨糖皮质激素对乙型病毒性肝炎重症化的阻断作用及安全性。方法回顾性分析60例乙型病毒性肝炎病例资料,选择入院时68μmol/L<血清总胆红素<171μmol/L的患者,分为激素治疗组和对照组,两组均给予常规抗病毒治疗,治疗组38例患者使用糖皮质激素,剂量个体化,同时预防不良反应发生。对照组患者常规使用甘草酸制剂。结果治疗组重症化率为10.5%,明显低于对照组,差异有统计学意义(P<0.05),两组出血、感染等不良反应的发生率无明显差异(P>0.05)。结论糖皮质激素用于治疗乙型病毒性肝炎高胆红素血症患者可改善肝功能,缩短凝血酶原时间,疗效明显,但要严格掌握适应证,把握好时机和疗程;积极采取综合预防措施,出血、感染等严重的不良反应少,是阻断高胆红素血症的乙型病毒性肝炎重症化的一种可供推荐的治疗方案。
Objective To investigate the blocking role and safety of glucocorticoid in the course of hepatitis B to deteriorate. MethodsThe clinical data of 60 hepatitis B patients were retrospectively analyzed,their serum total bilirubin（TBIL） were higher than 68 μmol/L and lower than 171 μmol/L.All patients were divided into treatment group and control group.These two groups were administrated regular antiviral drugs.Patients in treatment group were administrated glucocorticoid individually,meanwhile,protective steps were taken in order to prevent adverse reaction.Glycyrrhizicacid was used in control group regularly. ResultsThe incidence rate of severe hepatitis in treatment group was 10.5% and lower than that in control group,it had statistical difference（P0.05）.Incidence rates of adverse reaction such as hemorrhage and infection had no statistical difference between two groups（P0.05）. ConclusionGlucocorticoid can improve liver function and reduce prothrombin time in hepatitis B with hyperbilirubinemia.It has an obvious therapeutic effect and little side effects such as hemorrhage and infection.But the indication should be seriously mastered,the occasion and course of treatment properly controlled and protective steps positively executed.Glycyrrhizicacid is the recommended treatment for hepatitis B with hyperbilirubinemia and it can block hepatitis B to deteriorate.
出处
《胃肠病学和肝病学杂志》
CAS
2011年第3期272-274,共3页
Chinese Journal of Gastroenterology and Hepatology
基金
国家"十一五"科技重大专项子课题"抗病毒及免疫调节结合人工肝支持技术治疗乙型重型病毒性肝炎的应用"(2008zx10002-005)
YK2007090
