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目的 :观察膦甲酸钠治疗重型乙型肝炎的疗效及不良反应。方法 :选择亚急性重型肝炎 4例 ,慢性重型肝炎17例 ,所有患者HBVDNA阳性。在护肝、支持、对症等治疗基础上加用膦甲酸钠 3 g ,每日 2次 ,连续 4周 ;治疗前后观察症状、体征、肝功能、乙肝病毒标志物、HBVDNA的变化及不良反应。结果 :2 1例患者存活 15例 ;用药前后肝功能显著改善 ;15例患者HBVDNA得到复查 ,转阴 8例 ;14例HBeAg阳性 5例转阴 ,其中 1例出现HBeAg/抗HBe血清转换 ,用药期间 2例出现头晕 ,3例出现恶心、腹胀 ,1例出现皮疹。结论 :膦甲酸钠有明显的抑制HBV复制、降低血清病毒水平的作用 ,可以改善肝功能 ,改善预后 ,可用于重型乙型肝炎的治疗。
Objective: To observe the efficacy and adverse reactions of foscarnet in the treatment of severe hepatitis B Methods: Four cases of subacute severe hepatitis and 17 cases of chronic severe hepatitis were selected. All patients had positive HBVDNA. In the protection of liver, support, symptomatic treatment based on the use of foscarnet 3 g, 2 times a day for 4 weeks; before and after treatment of symptoms, signs, liver function, hepatitis B virus markers, HBVDNA changes and adverse reactions. RESULTS: Twenty-one patients survived in 15 cases. The liver function was significantly improved before and after treatment. HBVDNA was rechecked in 8 of 15 patients. In the 14 patients, 5 were HBeAg-negative, 1 of whom had HBeAg / anti-HBe seroconversion. 2 cases during which time dizziness, 3 cases of nausea, abdominal distension, 1 case of rash. Conclusion: Foscarnet significantly inhibits HBV replication and reduces serum levels of HBV, improves liver function, improves prognosis and can be used for the treatment of severe hepatitis B.