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1、乙肝病毒耐药导致慢性重型肝炎的抗病毒治疗临床疗效分析丁岗强①康谊①刘俊平①曾艳丽①侯环荣①魏君锋①尚佳①【摘耍】目的:分析乙肝病奇耐药导致慢性車型肝炎的抗病毒治疗临床疗效。方法:选取本院2009年12月-2012年12月收治的73例于院外口服核苛类似物进行抗乙肝病毒治疗后出现慢性垂世肝炎的患者为研究对象,按照入院顺序分为对照纽.38例和观察组35例。对照组给予常规的保肝、减黄、营养支持等对症治疗,观察组在对照纽的基础上继续给予核首类似物恩替K韦治疗。比较两纽治疗后死广率、HBV-DNA阴转率及两组患者治疗前后谷丙转氨酶(ALT)、血淸总胆红素(T-BILI).
2、白蛋白(ALB)、凝血酶原活动度(PTA)等肝功能指标变化。结果:治疗24周后,观察纽死亡率2.86%,明显低于对照纽的18.42%(字2=4.523,P=0.036),HBV-DNA阴转率8&57%,明显高于对照组的39.47%(字2=16.408,P=0.000)0两组患者治疗前ALT、ALB、TBIL、PTA比较差异均无统计学意义(P>0.05)。经过治疗后,对照组患者的ALT、TBIL均明显高于观察纽,而ALB、PTA均明显低于观察纽.,差异均有统计学意义(PV0.05)。结论:对于乙肝病毒耐药导致慢性重型肝炎的患者,抗病毒药物可以降低患者死亡率、提高
3、患者IIBV-DNA阴转率,促进肝脏生化功能提高,值得临床上推广应用。【关键词】乙肝病奇耐药:慢性重型肝炎:抗病奇治疗:临床疗效ClinicalAnalysisofAntiviralTherapyforChronicSevereHepatitisTriggeredbyDnig-fastHepatitisBVirus/'DINGGang-qiang,KANGYi»LIUJumping,elal.//MedicalInnovationofChina,2014,11(08):006-008【Abstract]Objective:Toanalyzetheclinica
4、lelleclofantiviraltherapyforchronicseverehepatitistriggeredbydnig•恰sthepatitisBvirus.Method:73patientswhodegeneratedintochronicseverehepatitisafterthetreatmentoforalnucleosideanalogsinourhospitalfromDecember2009toDecember2012wereselected♦andtheyweredividedintothecontrolgroupfor38cas
5、esandtheobserxaliongroupfor35cases.Thecontrolgroupwasgivensymptomatictreatmenlsuchasroutineliverprotection,anticholeplaniaandnutritionalsupport,etc,theobservationgroupwasgivennucleosideanaloguesentecavironthebasisofthecontrolgroup.Themortalityrate,HBV-DNAnegativeconversionratewereco
6、mparedbetweenthetwogroups;Atthesamelime,theserumliverfunctionindexesofalanineaminotransferase(ALT)•totalbilinibin(T-BILI),albumin(ALB)andprothrombinactivity(PTA)werealsodetectedandcontrastiveanalyzed.ResultAfter24wccks^treatment,themortalityrateofobservationgroupwas2.86%♦itwassignif
7、icantlylowerthan18.42%ofthecontrolgroup(字2=4.523,P=0.036)»thenegativerateofIIBV-DNAwas88.57%,itwashigherthan39.47%ofthecontrolgroup(字2=16.408,P=0.000).Inaddition,therewasnosignificantdifferenceinsemmALT,ALB,TBILandPTAlevelsbetweenthetwogroupsbeforetreatment(P>0.05):Aftertrealmenbthe
8、ALT,TBILinthecontro