肝衰竭预后研究与慢性乙型肝炎优化治疗疗效评价

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1、·华中科技大学硕士学位论文肝炎患者在ALT复常、病毒学应答方面有较好疗效，但疗效差别无统计学意义，而联合用药可减少耐药的发生。本课题创新点及意义：综合分析了湖北地区ALF病因构成及预后因素，客观评价了ALSS治疗HBV-ACLF近期疗效及预后生存，初步评估了核苷（酸）类似物优化治疗疗效。本研究可为今后临床中的重型肝炎或肝衰竭及慢性乙型肝炎抗病毒治疗提供借鉴。关键词：肝衰竭；慢性乙型肝炎；预后；人工肝支持系统；优化治疗本研究受国家传染病科技重大专项（2008ZX10002-011）、国家重点基础研究发展计划（973计划）（2005CB522901，2007CB512804，2009CB522

2、500）、国家自然科学基金（30170889，30271170，30400412，30571646，30700701，81001313，81101248）、科技部国际科技合作计划（2011DFA31030）、德中跨学科重大合作项目（TRR60）和中国博士后科学基金(20090460949)资助。4···华中科技大学硕士学位论文StudiesonprognosisofpatientswithliverfailureandevaluationoftheefficacyofoptimizedtreatmentforchronichepatitisBCandidate:JianKang1,2Sup

3、ervisor:Prof.Dong-liangYang1,YueChen21TeachingandresearchdivisionofInfectiousDiseases,XieheHospitalofTongjiMedicalCollege,HuazhongUniversityofScienceandTechnology,Wuhan,China.2TeachingandresearchdivisionofInfectiousDiseases,TaiheHospitalofHubeiUniversityofMedicine,Shiyan,China.AbstractObjective1.T

4、oreviewretrospectivelyconfertothenewstandardofALFetiologicfactorsandprognosisinpatientswithacuteliverfailure.2.Toinvestigateclinicalefficacy，theconsequencesofartificialliversupportsystemtreatmentandinfluencefactorsofprognosisinpatientswithHBVrelatedACLF.3.ToevaluatetheefficacyofOptimizedstrategyfo

5、rHBeAg-positionchronichepatitisBpatientswithlamifudineresistancereceivingADVplusLAMorADVmonotherapy.Methods1.Atotalof61inALFpatientswereidentified.Thecauses，laboratoryprofiles，prognosisinpatientswithacuteliverfailurewereinvestigated.2.Therewereatotalof56inHBV-ACLFpatientsintheresearch.Accordingtog

6、enderandage.，therewere28patientswhoreceivedALSSinobservationgroupcases,28patientsincontrolgroup.Thelaboratoryprofilesandprognosisintwo5···华中科技大学硕士学位论文groupswereinvestigated.1.79chronichepatitisBpatientswithLAMresistancewereramdomlyputinanobservationgrouporacontrolgroup.After24weeksoftreatment,seru

7、mHBVDNAlevelsweremeasuredandNormalizationofALT,drugresistancewerealsoconducted.Results1.ThemostcommonetiologyofALFinHubeiprovinceandneighboringregionswasHBVinducedin85.2%.BesidesALTandCr,therearesignificantdiffer