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目的:分析血浆置换联合恩替卡韦治疗高原地区乙型慢加急性肝衰竭的疗效。方法:将127例乙型慢加急性肝衰竭患者随机分4组:常规内科治疗组、恩替卡韦治疗组、血浆置换治疗组、血浆置换联合恩替卡韦治疗组,分析4组治疗前后血清谷丙转氨酶(ALT)、血清总胆红素(TBIL)、血清白蛋白(ALB)、凝血酶原活动度(PTA)、HBV-DNA等变化情况及患者治疗有效率。结果:血浆置换联合恩替卡韦治疗组患者的谷丙转氨酶、血清总胆红素均明显下降,血清白蛋白及凝血酶原活动度均显著提高,HBV-DNA阴转率高,患者治疗有效率高。结论:血浆置换联合恩替卡韦能有效改善高原地区乙型慢加急性肝衰竭患者的生化指标,促进HBV-DNA阴转,提高临床有效率,防止因高原低氧环境导致的肝衰竭进一步加重,获得最佳疗效,改善患者预后,是高原地区治疗乙型慢加急性肝衰竭的一种安全有效的方法。
Objective: To analyze the efficacy of plasma exchange combined with entecavir in the treatment of acute type B acute liver failure in high altitude area. Methods: A total of 127 patients with acute and chronic hepatitis B were randomly divided into 4 groups: conventional medical treatment group, entecavir treatment group, plasma exchange treatment group and plasma exchange combined with entecavir treatment group. The changes of serum alanine aminotransferase (ALT) ), Serum total bilirubin (TBIL), serum albumin (ALB), prothrombin activity (PTA), HBV-DNA and other changes and patient treatment efficiency. Results: Plasma alanine aminotransferase (ALT) and serum total bilirubin were significantly decreased in patients treated with plasma exchange and entecavir, serum albumin and prothrombin activity were significantly increased, HBV-DNA negative conversion rate was high, and patients treated effectively. Conclusion: Plasma exchange combined with entecavir can effectively improve the biochemical indexes of patients with B type acute and acute liver failure in plateau area, promote HBV-DNA to negative conversion, improve clinical efficiency and prevent further worsening of liver failure caused by plateau hypoxia environment Good curative effect and improving the prognosis of patients are a safe and effective method for treating type B acute and acute liver failure in the plateau area.