期刊文献+

糖皮质激素降阶梯联合抗病毒治疗对早期乙型重症肝炎的阻断效果及安全性分析 被引量:8

The efficacy and safety analysis of glucocorticoid deescalation combined antiviral therapy on severe hepatitis B
下载PDF
导出
摘要 目的观察糖皮质激素降阶梯治疗联合抗病毒治疗对早期重症乙型肝炎的阻断效果及其安全性。方法选取该科治疗的早期重症肝炎患者49例,分为观察组(n=24)和对照组(n=25)。对照组采用常规综合治疗,观察组在常规治疗基础上联合糖皮质激素降阶梯治疗。观察并比较两组患者肝功能、凝血酶原等指标的改善以及临床症状、病死率的差异。结果观察组和对照组的病死率分别为16.7%和32.0%,差异有统计学意义(P<0.05)。观察组消化道改善,黄疸消退时间均短于对照组(P<0.05),而消化道出血、感染率差异无统计学意义(P>0.05)。治疗1个月后,两组患者的总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、凝血酶原时间(PT)及凝血酶原活动度(PTA)均较治疗前显著改善(P<0.05),且观察组上述指标的改善显著优于对照组(P<0.05)。两组存活患者治疗后乙型肝炎病毒(HBV)DNA较治疗前显著降低(P<0.05),且HBV DNA、转阴率组间比较差异无统计学意义(P>0.05)。结论糖皮质激素降阶梯联合抗病毒治疗早期重症肝炎是一种有效、安全的方法,可阻断重型肝炎发展,降低患者病死率。 Objective Observe the efficacy and safety of glucocorticoid deescalation combined antiviral therapy on severe hepati‐tis B .Methods Forty‐nine patients with early severe hepatitis were selected and divided them into observation group(n=24) and control group (n=25) randomly .Control group were given the conventional synthetic therapy while observation group were given conventional synthetic therapy combined glucocorticoid deescalation therapy .Then compare the differences of TBIL ,ALT ,PTA be‐fore and after treatment ,and the improvement time of syndrome and death rate between two groups .Results The death rate in ob‐servation group and control group were 16 .7% and 32 .0% respectively(P〈0 .05) ,the improvement time of syndrome in observa‐tion group were shorten than control group(P〈0 .05) ,and there was no statistical difference in bleeding and infection rate between two groups(P〉0 .05) .After the treatment ,the TBIL ,ALT ,PT were improved in both two groups(P〈0 .05) .But the observation group had better improvement than control group ,the difference had statistical significance(P〈0 .05) .After treatment ,the changes of HBV DNA between two groups showed no significant difference(P〉 0 .05) .Conclusion Glucocorticoid deescalation therapy could decrease the death rate ,shorten the syndrome lasting time in treating severe hepatitis B .It was an effective and safety meth‐od .
出处 《重庆医学》 CAS CSCD 北大核心 2014年第33期4485-4486,4489,共3页 Chongqing medicine
关键词 糖皮质激素类 降阶梯治疗 重症肝炎 早期 glucocorticoids deescalation therapy severe hepatitis B early stage
  • 相关文献

参考文献12

二级参考文献79

共引文献3476

同被引文献62

  • 1杨波,吴元凯,吴宗华,谢伟东,许珏,高志良,陈禄彪,谢仕斌,田德英.小剂量糖皮质激素短程治疗慢性乙型肝炎重型倾向的近期疗效[J].国际流行病学传染病学杂志,2013,40(3). 被引量:5
  • 2Ramsoekh D, Taimr P, Vanwolleghem T, et al. Reversible severe hepatitis in anorexia nervosa: A case report and overview[J]. Eur J Gastroenterol Hepatol, 2014, 26(4): 473-477.
  • 3He B, Zhang Y, L ti MH, et al. Glucocorticoids can increase the survival rate of patients with severe viral hepatitis B: A meta-analysis[J]. Eur J Gastroenterol Hepatol, 2013, 25(8): 926-934.
  • 4Grosu HB,Eapen GA,Morice RC,et al.Stents are associated with increased risk of respiratory infections in patients undergoing airway interventions for malignant airways disease[J].Chest,2013,144(2):441-449.
  • 5Tian J,Huang K,Krishnan S,et al.RAGE inhibits human respiratory syncytial virus syncytium formation by interfering with F-protein function[J].J Gen Virol,2013,94(Pt 8):1691-1700.
  • 6Sun L,Cornell TT,LeVine A,et al.Dual role of interleukin-10in the regulation of respiratory syncitial virus(RSV)-induced lung inflammation[J].Clin Exp Immunol,2013,172(2):263-279.
  • 7Wurzel DF,Marchant JM,Clark JE,et al.Respiratory virus detection in nasopharyngeal aspirate versus bronchoalveolar lavage is dependent on virus type in children with chronic respiratory symptoms[J].J Clin Virol,2013,58(4):683-688.
  • 8Hare KM,Marsh RL,Binks MJ,et al.Quantitative PCR confirms culture as the gold standard for detection of lower airway infection by nontypeable Haemophilus influenzae in Australian indigenous children with bronchiectasis[J].J Microbiol Methods,2013,92(3):270-272.
  • 9Mokart D,Slehofer G,Lambert J,et al.De-escalation of antimicrobial treatment in neutropenic patients with severe sepsis:results from an observational study[J].Intensive Care Med,2014,40(1):41-49.
  • 10Garnacho-Montero J,Gutiérrez-Pizarraya A,Escoresca-Ortega A,et al.De-escalation of empirical therapy is associated with lower mortality in patients with severe sepsis and septic shock[J].Intensive Care Med,2014,40(1):32-40.

引证文献8

二级引证文献39

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部