恩替卡韦联合血浆置换治疗慢性乙型重型肝炎的研究

目的初步探讨恩替卡韦联合血浆置换治疗慢性乙型重型肝炎患者的疗效。方法选取40例慢性乙型重型肝炎患者,在常规内科治疗及恩替卡韦0.5 mg/d抗病毒治疗基础上联合血浆置换治疗。同时选取38例慢重肝患者为对照组,给予常规内科治疗及恩替卡韦0.5 mg/d抗病毒治疗。比较2组患者在慢性乙型重型肝炎早、中和晚期存活率的差异。结果联合血浆置换组生存率为72.5%,而对照组生存率为50%(χ2=4.168,P=0.041)。其中,中期慢重肝患者联合血浆置换治疗,其生存率为72.2%,而对照组生存率为38.9%(χ2=4.050,P=0.044),早期和晚期慢重肝患者联合血浆置换治疗,其生存率与对照组比差异无统计学意义(P0.05)。结论慢性乙型重型肝炎中期患者采用恩替卡韦联合血浆置换治疗能提高患者生存率。

Efficacy of combination therapy of entecavir and Plasma Exchange for the treatment of severe acute exacerbation of chronic hepatitis B

Objective To investigate the efficacy of combination therapy of entecavir and plasma exchange for the treatment of severe acute exacerbation of chronic hepatitis B.Method 78 patients with severe acute exacerbation of chronic hepatitis B were divided into combination therapy group of entecavir and plasma exchange（40） and solo therapy control group of entecavir（38）.Result The survival rate of combination therapy group was 72.5%,while that of the control group was 50%（chip-square=4.168,P=0.041）.Survival rate in patients with middle stage of severe acute exacerbation of chronic hepatitis B was 72.2%,and in control group it was 38.9%（chip-square=4.050,P=0.044）.There were no significant difference in early or final stage of severe acute exacerbation of chronic hepatitis B between the two groups（P〉0.05）.Conclusion Combination therapy of entecavir and plasma exchange may improve the survival rate of patients with severe acute exacerbation of chronic hepatitis B,especially for patients in the middle stage of the disease.