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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(P>0.05)。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。
Objective To investigate the efficacy of entecavir combined with plasma exchange in the treatment of patients with chronic severe hepatitis B. Methods Forty patients with chronic severe hepatitis B were enrolled in this study. They were treated with routine medical therapy and entecavir 0.5 mg / d antiviral therapy combined with plasma exchange. At the same time, 38 patients with chronic severe hepatitis were selected as the control group and received routine medical treatment and entecavir 0.5 mg / d antiviral therapy. The differences of early, middle and late survival rates in patients with chronic severe hepatitis B were compared between the two groups. Results The survival rate of combined plasma exchange group was 72.5%, while that of control group was 50% (χ2 = 4.168, P = 0.041). Among them, the medium-term patients with chronic severe hepatitis combined plasma exchange therapy, the survival rate was 72.2%, while the control group survival rate was 38.9% (χ2 = 4.050, P = 0.044), early and late patients with severe chronic liver replacement plasma exchange treatment There was no significant difference in survival rate and control group (P> 0.05). Conclusion Entecavir combined with plasma exchange therapy can improve the survival rate of patients with mid-term chronic severe hepatitis B.