前列地尔注射液辅助治疗慢性乙型重度肝炎的疗效观察

目的观察凯时辅助治疗慢性乙型重度肝炎的疗效及安全性。方法 2010年1月～2012年4月间诊断明确且符合标准的慢性乙型重度肝炎患者120例,随机分为凯时组(n=60)和对照组(n=60),所有患者入院后均接受多烯磷脂酰胆碱、苦黄、甘草酸二胺、还原型谷胱甘肽,以及新鲜冰冻血浆和白蛋白等综合治疗,但不予血浆置换。在此基础上,凯时组加用凯时(前列地尔注射液)20μg加入生理盐水100mL中静脉滴注,每日1次,对照组仅给予生理盐水100mL静脉滴注,每日1次,疗程均为14d。观察并比较两组病例的平均住院日、肝功能改善、治疗总有效率及不良反应发生情况。结果凯时组平均住院日为(15.9±5.2)d,明显短于对照组平均住院日(23.5±6.6)d,差异有统计学意义(P<0.05)。凯时组与对照组总有效率分别为98.33%、96.67%,差异无统计学意义(P>0.05)。治疗后两组病例肝功能各项指标较治疗前均有明显改善,差异有统计学意义(P<0.05),但凯时组谷丙转氨酶(ALT)、总胆红素(TBil)较对照组下降幅度更明显(P<0.05),血清白蛋白(ALB)水平较对照组上升幅度更明显,差异有统计学意义(P<0.05)。治疗期间两组病例均未观察到皮疹、发热、头晕、头痛、腹痛、局部血管刺激征、静脉炎等不良反应。结论凯时辅助治疗慢性重度肝炎安全有效,值得临床推广。

Objective To explore the efficacy and safety of alprostadil injection for severe chronic hepatitis B. Methods 120 patients with severe chronic hepatitis B were randomLy assigned to receive alprostadil injection（trial group） or normal saline（control group） for 14 days. Serum levels of TBil, ALT, ALB were measured and compared between two groups. Length of stay in hospital, total effective rate, drug side effect were also observed and compared between two groups. Results Length of stay in hospital in trial group was shorter than that in control group（P0.05）. Total effective rate of trial group and control group were 98.33% and 96.67% respectively, without significant difference（P0.05）. Compared in the same group, levels of TBil, ALT was significantly lower after treatment in both groups（P0.05）, levels of ALB was significantly higher after treatment in both groups（P0.05）. However, the improving extent of the trial group was more obvious than that in control group（P0.05）. No drug side effect was observed in both groups. Conclusion Alprostadil was effective and safe for severe chronic virus hepatitis and worthy of further application.