人免疫球蛋白联合抗菌药物治疗中晚期肝病感染患者的临床效果研究

Clinical effect of human immunoglobulin combined with antibiotic therapy in patients with advanced liver infection

目的 探讨对中晚期肝病并发感染不同Child-Pugh评分的患者实施人免疫球蛋白联合抗菌药物治疗的临床效果,为临床治疗晚期肝病并发感染提供理论指导和依据。方法 选取2013年2月-2015年2月在医院接受治疗的中晚期肝病并发感染患者90例作为研究对象,将其随机分为观察组与对照组,每组各45例;对照组患者仅使用抗菌药物进行治疗,观察组患者在对照组治疗的基础上联合使用人免疫球蛋白实施治疗;根据两组肝硬化患者的肝脏储备功能进行量化评估（Child-Pugh评分）,比较两组患者的临床治疗效果,采用SPSS16.0软件进行统计分析。结果 治疗一周后,两组Child-Pugh评分〈10分患者血清胆红素浓度和凝血酶原时间比较差异不明显;Child-Pugh评分10~15分观察组患者的血清胆红素浓度明显低于对照组,凝血酶原时间明显高于对照组,两组比较差异均有统计学意义;两组Child-Pugh评分〈10分的患者抗感染有效率无明显差异,而10~15分的患者观察组有效率明显高于对照组,差异有统计学意义。结论 Child-Pugh评分10~15分的中晚期肝病患者,应用人免疫球蛋白联合抗菌药物治疗,能明显降低血清胆红素浓度和提高凝血酶原时间,提高抗感染的疗效,值得临床推广使用。

OBJECTIVETo investigate clinical effect of human immunoglobulin combined with antibiotic therapy in patients with advanced liver disease accompanying different Child-Pugh scores of infection, and to provide theoreti- cal guidance and basis for clinical treatment of advanced liver disease complicated by infection. METHODSA total of 90 patients with advanced liver disease complicated by infection treated in our hospital from Feb. 2013 to Feb. 2015 were selected as study objects. They were randomly divided into observation group and control group with 45 cases of patients in each group. Patients in the control group were only given antibiotics for anti-infective therapy, while based on the treatment of the control group, patients in the observation group were also given human immu- noglobulin combined with antibiotic therapy. Quantitative assessment （Child-Pugh score） was carried out on the basis of liver reserve function in patients with cirrhosis of the two groups, and clinical efficacy of the two groups was compared The results were statistically analyzed by software SPSS16.0. RESULTSAfter one-weeks treatment, the difference of serum bilirubin concentration and prothrombin time of the two groups of patients with Child-Pugh score 〈10 points was not obvious. For patients with Child-Pugh score ranging from 10 to 15 points, serum biliru- bin concentration of the observation group was significantly lower than that of the control group, while prothrom- bin time of the observation group was significantly higher than that of the control group. The effective rates of anti-infection for patients of the two groups with Child-Pugh score 〈10 points had no significant difference, but effective rate of anti-infection for patients of the observation group with Child-Pugh score ranging from 10 to 15 points was significantly higher than that of the control group. CONCLUSIONFor patients with advanced liver dis- ease with Child-Pugh score ranging from 10 to 15 points, the use of human immunogiobulin combined with antibi- otic therapy can significantly reduce serum bilirubin concentration, increase prothrombin time, and enhance the ef- ficacy of anti-infective, so it is worthy of promotion.