抗病毒治疗对慢性乙型重型肝炎近期预后影响的分析

Analysis of Influence on Short-Term Prognosis of Chronic Severe Hepatitis B Patients with Antiviral Therapy

目的:回顾性总结抗病毒治疗对慢性乙型重型肝炎近期预后的影响,以求提高慢性乙型重症肝炎的治疗水平。方法:回顾性分析84例慢性乙型重型肝炎患者的临床资料。抗病毒组(44例)在内科常规治疗基础上,加用核苷类抗病毒药物;对照组(40例)仅使用内科常规治疗。分析比较治疗后2周、4周两组患者生化指标、病毒转阴率、MELD评分、生存率及并发症等因素变化。结果:1.治疗后2周结果:两组的TBiL、PTA、INR差异具有统计学意义(P<0.05)其他指标无统计学意义;MELD评分在抗病毒治疗组治疗前后差异有统计学意义(P<0.05),在对照组治疗前后无统计学差异(P>0.05);抗病毒治疗组与对照组治疗后比较,MELD评分差异有统计学意义(P<0.05)。2.抗病毒治疗4周结果:抗病毒治疗组与对照组两组病毒转阴率差异有统计学意义(P<0.05);两组生存率差异有统计学意义(P<0.05);合并并发症的患者中两组生存率差异有统计学意义,P<0.05。结论:抗病毒治疗可以改善生化指标,提高病毒转阴率,降低MELD评分,提高生存率,改善慢性乙型重型肝炎的预后。

Objective：To explore the influence of short-term prognosis of chronic severe hepatitis B patients treated with antiviral therapy. To improve the level of treatment in patients with chronic severe hepatitis B. Method： A retrospective analysis was performed in 84 patients with chronic severe hepatitis B .44 patients in antiviral therapy group were treated with nucleosides antiviral drugs besides routine supportive therapy.40 patients in control group were only applied with routine supportive therapy. To observe every index after 2 and 4 weeks, analysis the biochemical indicator, negative conversion rate of HBVDNA, MELD score, virus survival rate, predictive mortality and actuality mortality of two groups. Result： 1.After 2weeks treatment the indexs are as follow： There are difference between two groups ofTBiL PTA INR （P〈0.05）. Another indexs have no differences （P〉0.05）. In antiviral therapy group, MELD score has significant difference between before and after treatment （P〈0.05）. Control group has no significant difference in MELD score between patients before treatment and after treatment （P〉0.05）. After 2 weeks treatment there were significant difference in MELD score between patients in antiviral therapy group and control group （△P〈0.05）. 2. After 4 weeks treatment the indexs are as follow： After 4 weeks treatment, there are significant difference in negative conversion rate of HBVDNA between two groups （P〈0.05）. There are significant difference in the survival rate of patients between antiviral therapy group and control group （P〈0.05）. There are significant difference in patients who have complication between antiviral therapy group and control group （P〈0.05）. Conclusion： Antiviral therapy can improve the biochemical indicator, increase the conversion rate of HBVDNA, depress the MELD score, increase the the survival rate, improve the prognosis of chronic severe hepatitis B.