抗病毒联合糖皮质激素和血浆置换早期干预肝衰竭倾向乙肝患者观察

目的观察早期应用糖皮质激素和人工肝血浆置换在肝衰竭倾向患者治疗中的作用。方法选择91例有肝衰竭倾向的患者,其中治疗组49例,在综合保肝和抗乙肝病毒治疗基础上加用糖皮质激素或糖皮质激素联合人工肝血浆置换治疗;对照组42例,仅应用保肝联合抗病毒治疗。结果治疗过程中及治疗结束时,治疗组肝功能及凝血酶原的改善较对照组显著。治疗组临床好转率优于对照组,肝衰竭发生率低于对照组。结论应用糖皮质激素和人工肝血浆置换治疗,可早期阻断有肝衰竭倾向的慢性乙型肝炎疾病的进展,降低肝衰竭的发生率和慢性肝病的病死率,为肝衰竭的早期防治提供临床依据。

Effect of anti-virus combined with glucocorticoids and plasma exchange on patients with hepatitis B with tendency to Hepatargia

Objective To observe the effect of glucocorticoid and artificial liver plasma exchange in treatment of patients who had hepatargia tendency.Methods 91 patients with hepatargia tendency were assigned into the treatment group(n=49) and the control group(n=42).Based on the natural liver protection and anti-hepatitis B virus treatment,the treatment group received glucocorticoid or glucocorticoid in combination with artificial liver plasma exchange.The control group only received natural liver protection and anti-hepatitis B virus treatment.Results Compared with the control group,liver function and prothrombin in the treatment group was significantly improved during and after treatment.The clinical improvement rate was higher and the hepatargia incidence was lower.Conclusion Application of glucocorticoids and artificial liver plasma exchange,which can be blocked at an early stage of chronic hepatitis B tendency to hepatargia,reduces the incidence of liver failure and mortality of chronic liver disease,and provides a clinical basis for early prevention and treatment of hepatargia.