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目的观察磷甲酸钠治疗慢性重型乙型肝炎(早、中期)的疗效。方法选择慢性重型乙型肝炎患者83例,随机分治疗组43例及对照组40例。治疗组在综合治疗基础上,加用磷甲酸钠3.0g,每日2次,连续4周;治疗前后观察患者的症状、体征、肝肾功能、凝血酶原活动度、乙肝病毒标志物、HBV-DNA定量等变化。结果治疗组总有效人数40例,无效3例,对照组总有效人数30例,10例无效,治疗组总有效人数明显高于对照组(P<0.05),随访6个月,治疗组病死率低于对照组(P<0.05)。4周后治疗组血清SB、AST、PTA、AKP、γ-GT均明显改善,与对照组相比差异有统计学意义(分别为P<0.01、P<0.05、P<0.01、P<0.05、P<0.05)。HBV-DNA 2周后下降明显,与治疗前比较差异有统计学意义(P<0.01),其中HBV-DNA 9例转阴,4周后25例转阴,而对照组治疗前后差异无统计学意义(P>0.05)。结论磷甲酸钠具有明显的抑制HBV复制、调节机体免疫的作用,可以改善肝功能,减少并发症的发生,降低死亡率。
Objective To observe the efficacy of sodium phosphate in the treatment of chronic severe hepatitis B (early and midterm). Methods Eighty-three patients with chronic severe hepatitis B were randomly divided into treatment group (n = 43) and control group (n = 40). Treatment group on the basis of comprehensive treatment, plus 3.0g of sodium phosphate, 2 times a day for 4 weeks; before and after treatment of patients with symptoms and signs, liver and kidney function, prothrombin activity, hepatitis B virus markers, HBV- DNA quantitative changes. Results The total effective number of the treatment group was 40 cases, 3 cases were ineffective, the total effective number of the control group was 30 cases and 10 cases were ineffective. The total effective number of the treatment group was significantly higher than that of the control group (P <0.05) Lower than the control group (P <0.05). After 4 weeks, serum SB, AST, PTA, AKP, γ-GT in the treatment group were significantly improved compared with the control group (P 0.01, P 0.05, P 0.01, P 0.05, P <0.05). HBV-DNA decreased significantly after 2 weeks and was significantly different from that before treatment (P <0.01). HBV-DNA was negative in 9 cases and negative in 25 cases after 4 weeks, while there was no significant difference in the control group before and after treatment Significance (P> 0.05). Conclusion Phosphoric acid sodium can obviously inhibit the HBV replication and regulate the immunity of the organism. It can improve the liver function, reduce the complication and reduce the mortality rate.