抗病毒治疗对乙型肝炎相关慢加急性肝衰竭近期及远期疗效的影响

姜立胜; 李用国; 陈姝; 兰英华

抗病毒治疗对乙型肝炎相关慢加急性肝衰竭近期及远期疗效的影响

哈尔滨医科大学附属第一医院感染科

基金项目:

国家科技重大专项“十二五”课题病毒性肝炎转归预警预测的研究(2012ZX10002007)；

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中图分类号: R512.62
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出版历程
- 出版日期: 2013-02-20

Short-term and long-term efficacy of antiviral treatment of patients with HBV-associated acute-on-chronic liver failure

Research funding:

摘要

摘要:
目的回顾性分析抗病毒治疗对乙型肝炎相关慢加急性肝衰竭近期及远期疗效的影响。方法 51例乙型肝炎相关慢加急性肝衰竭病例,按有无应用抗病毒药物分为抗病毒组和未抗病毒组,查阅住院期间的病例并记录随访5年内的资料,比较两者之间近期及远期疗效的差别。结果近期疗效比较:抗病毒组和未抗病毒组出院时好转率分别为70.00%和36.36%,两者之间差异有统计学意义(P<0.05)。远期疗效比较:抗病毒组12、36和60个月累积生存率分别为76.40%、72.10%和72.10%;未抗病毒组12、36和60个月累积生存率分别为36.36%、27.30%和27.30%,两者之间差异有统计学意义(P<0.05)。结论抗病毒治疗可明显改善乙型肝炎相关慢加急性肝衰竭患者的预后,提高生存率,延长存活时间。
- 肝功能衰竭 /
- 肝炎,乙型
Abstract:
Objective To analyze the impact of antiviral therapy on short-term and long-term prognosis of patients with hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF) in a retrospective study.Methods A total of 51 patients with HBV-ACLF who had been treated with antiviral drugs (antiviral group) and who did not receive antiviral therapy (non-antiviral group) were retrospectively analyzed.The medical records from in-hospital treatment and five years of follow-up were comparatively analyzed for the two groups to assess differences in patient outcome and determine the clinical benefit associated with antiviral therapy.Results The recovery rate at hospital discharge was significantly higher for patients in the antiviral group (70.00% vs.non-antiviral group:36.36%, P<0.05) .In addition, the cumulative survival rates were significantly higher for the antiviral group during follow-up at 12, 36 and 60 months (antiviral group vs.non-antiviral group:76.40% vs.36.36%, 72.10% vs.27.30%, and vs.27.30%;all P<0.05) .Conclusion Antiviral therapy can significantly improve prognosis and survival rate, as well as time to death, of HBV-ACLF patients.
- liver failure /
- hepatitis B

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参考文献(15)

[1]Lee WM, Squires RH, Nyberg SL, et al.Acute liver failure:Summaryof a workshop[J].Hepatology, 2008, 47 (4) :1401-1415.

[2] 胡瑾华, 刘晓燕, 王慧芬, 等.1977例急性、亚急性、慢加急性肝衰竭患者的病因与转归分析[C].第一届全国疑难重型肝病大会、第四届全国人工肝及血液净化学术年会论文集, 2008:321.

[3]Leifeld L, NatterMann J, Fielenbach M, et al.Intrahepatic activa-tion of caspasces in human fulminant hepatic failure[J].Liver Int, 2006, (26) :672-879.

[4] Liver Failure and Artificial Liver Group, Chinese Society of Infec-tious Diseases, Chinese Medical Association;Severe Liver Diseasesand Artificial Liver Group, Chinese Society of Hepatology, ChineseMedical Association.Diagnostic and treatment guidelines for liverfailure[J].Chin J Infect Dis, 2006, 24 (6) :422-425. (inChinese) 中华医学会感染病学分会肝衰竭与人工肝学组, 中华医学会肝病学分会重型肝病与人工肝学组.肝衰竭诊疗指南[J].中华传染病杂志, 2006, 24 (6) :422-425.

[5]Artificial Liver Group, Chinese Medical Association of Infectious andParasitic Diseases.Indication, contraindication, and therapeutic evalu-ation of artificial liver support system[J].Chin J Hepatol, 2002, 10 (6) :405. (in Chinese) 中华医学会传染病与寄生虫学会人工肝学组.人工肝支持系统的适应证、禁忌证和疗效判断[J].中华肝脏病杂志, 2002, 10 (6) :405.

[6]Kamath PS, Wiesner RH, Malinchoc M, et al.A model to predictsurvival in patients with end-stage liver disease[J].Hepatology, 2001, 33 (2) :464-470.

[7]李兰娟, 王宇明.传染病学[M].北京:人民卫生出版社, 2008:65-79.

[8]Ye YN, Gao ZL.Three attacks in the development of HBV-relatedliver failure[J].Infect Dis Info, 2009, 22 (5) :276-279. (inChinese) 叶一农, 高志良.乙型肝炎肝衰竭发生机制中的三重打击[J].传染病信息, 2009, 22 (5) :276-279.

[9]European Association for the Study of the Liver.EASL Clinical PracticeGuidelines:Management of chronic hepatitis B virus infection[J].JHepatol, 2012, Mar 20.[Epub ahead of print]

[10]Liaw YF, Kao JH, Piratvisuth T, et al.Asian-Pacific Consensusstatement on the management of chronic hepatitis B:A 2012 update[J].Hepatol Int, 2012, 6 (3) :531-561.

[11]Tillmann HL, Hadem J, Leifeld L, et al.Safety and efficacy of lami-vudine in patients with severe acute or Fulminant hepatitis B, amulti-cener experience[J].Viral Hepat, 2006, 13 (4) :256-263.

[12] Chen T, He Y, Liu X, et al.Nucleoside analogues improve theshort-term and long-term prognosis with hepatitis B virus-relat-ed acute-on-chronic liver failure[J].Clin Exp Med, 2011, Oct15.[Epub ahead of print]

[13]Chen J, Han JH, Liu C, et al.Short-term entecavir therapy ofchronic severe hepatitis B[J].Hepatobiliary Pancreat Dis Int, 2009, 8 (3) :261-266.

[14]Zhong XH, Yuan J, Yang Y, et al.Investigation of the liver failurepatients infected with hepatitis B virus treated with entecavir[J].JClin Hepatol, 2009, 25 (5) :331-333. (in Chinese) 钟旬华, 袁静, 杨艳, 等.恩替卡韦治疗乙型肝炎肝衰竭患者临床研究[J].临床肝胆病杂志, 2009, 25 (5) :331-333.

[15]Wong WW, Wong GL, Tsang SW, et al.Long-term follow-up oflamivudine treatment in patients with severe acute exacerbation ofhepatitis Be antigen-positive chronic hepatitis B[J].Antivir T-her, 2008, 13 (4) :571-579.

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