前列地尔治疗慢性重型肝炎临床分析

Clinical Observation of Alprostadil in the Treatment of 65 Patients with Chronic Severe Viral Hepatitis

目的探讨前列地尔对重型肝炎的疗效。方法107例慢性重型肝炎患者随机分为治疗组65例，对照组42例。对照组予常规内科综合治疗（应用甘草酸制剂、门冬氨酸钾镁、还原型谷胱甘肽、促肝细胞生长素、白蛋白、血浆等）；治疗组在综合治疗基础上加用前列地尔10～20ug，溶于5％葡萄糖注射液100mL中静脉滴注，1次／d，疗程为4wk。结果治疗组对重型肝炎的有效率为70．76％，对照组有效率为35．71％，有非常显著性差异（P〈0．001）；治疗组疗程结束后TBIL、r-GT下降和PTA升高的幅度等改变与对照组比较差异有显著性（P〈0．005）。结论前列地尔临床应用安全性高，及早给药对慢性重型肝炎有较好疗效，尤其在降低血清胆红素和改善凝血酶原活动度方面，可作为内科综合疗法的主要药物之一。

Objective To study on the therapeutic effect of alprostadil in chronic severe viral hepatitis. Methods 107 cases of chronic severe viral hepatitis were randomly divided into treatment group （65 cases） and control group （42 cases）. The control group only received the routine medical therapy （preparation of glycyrrhizic acid, potassium, glutathione, promoting hepatocyte growth factor, albumin plasma etc）, the treatment group was treated with alprostadil on the basis of routine medical therapy, and the group was daily intravenous alprostadil 10-20g dissolved in 5% glucose injection 100ml, 4 weeks as one treatment course. Results Alprostadil is an effective for severe viral hepatitis, the effective rate was 70.76% in treatment group, the effective rate of control group was 83.78%, there was a significant difference （P〈0.01）. After one treatment course, the treatment group compared with the control group, there was a significant difference （P〈0.005） in the exchange range of TBIL, r-GT decreased, and PTA increased. Conclusions Alprostadil clinical application was highly safe, there was a good effect in early treatment, especially in reducing serum bilirubin and improving prothrombin active degree, it will become one main drug of routine medical therapy.