糖皮质激素联合胸腺肽治疗亚急性重症肝炎的临床观察

Clinical study on two therapies of subacute severe viral hepatitis

目的 观察微量糖皮质激素联合胸腺肽对亚急性重症肝炎的治疗效果。方法 回顾性分析二组亚急性重症肝炎患者 112例 ,治疗组 5 5例在综合疗法 (白蛋白、新鲜血浆、能量合剂、维生素等 )基础上加用微量糖皮质激素 (地塞米松单日剂量不超过 3mg)以及胸腺肽。对照组 5 7例仅采用综合疗法。结果 治疗组 5 5例中死亡 17例 ,病死率 4 4 % ,对照组 5 7例中死亡 4 2例 ,病死率 74 % (P <0 .0 1)。而肝肾综合征、出血以及继发感染二组差异有显著性 ,治疗组不上升反而下降 (P <0 0 1)。结论 微量糖皮质激素联合胸腺肽对降低亚急性重症肝炎的病死率有良好效果。

Objective To observe the efficiency of two therapies on subacute severe viral hepatitis with low dosage of glucocordicin and thymosin. Methods 112 cases of subacute severe viral hepatitis diagnosed according to the criteria (PTA≤40 of all the cases) were divided into two groups. The therapeutic group were 43 men and 12 women, 18～55 years, and treated by adding two therapies (low dosage of glucocordicin and thymosin ) within 3～4 months; while the control group were 46 men and 9 women, 16～51 years, and treated by general combined therapy within 3～4 months. The mortality, incidence of hepatorenal syndrome, secondary infection and hemorrhagic were analyzed after the treatments. Results The mortality of was 44% (17/55) in the two therapy group vs 74% (42/57) in the control group, P<0.01. And the therapeutic group were lower than controlled group in incidences of hepatorenal syndrome, secondary infection and hemorrhagic,P<0.01. Conclusion The two therapies are effective in reducing the mortality of subacute severe viral hepatitis.