抗病毒联合血浆置换治疗慢性重型乙型肝炎的疗效

Curative effects of antiviral therapy combined with plasmapheresis on patients with chronic severe type B hepatitis

目的总结抗病毒联合血浆置换治疗慢性重型乙型肝炎的疗效。方法收集给予人工肝血浆置换治疗的慢性乙型重型肝炎患者156例临床资料,分为抗病毒组63例(拉米夫定或恩替卡韦)和非抗病毒组93例,分析两组治疗效果、HBV-DNA阳性率及肝功能检查结果。结果抗病毒组总有效率(54.0%)显著高于非抗病毒组(38.7%);病死率(33.3%)显著小于非抗病毒组(52.7%);HBV-DNA阳性率(26.5%)小于非抗病毒组(50.0%);TB、ALT、AST、PT均显著低于非抗病毒组;拉米夫定与恩替卡韦组有效率、病死率、HBV-DNA阳性率无显著差异。结论抗病毒联合血浆置换可显著提高慢性重型乙型肝炎患者的生存率。

Objective To analyze the curative effects of antiviral therapy combined with plasmapheresis on patients with chronic severe type B hepatitis.Methods The clinical data of 156 patients with chronic severe type B hepatitis receiving the artificial hepatic plasmapheresis were collected.They were divided into antiviral treatment group who received lamivudine or entecavir（63 cases）and non-antiviral treatment group（93 cases）.The curative effects,HBV-DNA positive rate and results of liver function test were compared between the two groups.Results The total effective rate of the antiviral treatment group（54.0%）was significantly higher than that of the non-antiviral treatment group（38.7%）.The case fatality（33.3%）and the HBV-DNA positive rate（26.5%）of the antiviral treatment group were significantly lower than those of the non-antiviral treatment group.TB,ALT,AST and PT were also significantly lower in the antiviral treatment group.There were no significant differences in effective rate,case fatality and HBV-DNA positive rate between the lamivudine and entecavir groups.Conclusion Antiviral therapy combined with plasmapheresis can significantly increase the survival rate of patients with chronic severe type B hepatitis.