抗病毒治疗对失代偿期乙型肝炎肝硬化患者远期预后的影响

杨汉泽

doi:10.3969/j.issn.1001-5256.2016.06.016

抗病毒治疗对失代偿期乙型肝炎肝硬化患者远期预后的影响

DOI: 10.3969/j.issn.1001-5256.2016.06.016

杨汉泽

四川省资阳市乐至县人民医院感染科

详细信息

中图分类号: R512.62;R575.2
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出版历程
- 出版日期: 2016-06-20

Effect of antiviral therapy on long-term prognosis of patients with decompensated hepatitis B cirrhosis

Yang HanZe

摘要

摘要: 目的探讨抗病毒治疗对失代偿期乙型肝炎肝硬化患者远期预后的影响。方法收集2009年5月-2012年5月于资阳市乐至县人民医院住院次数≥3次的失代偿期乙型肝炎肝硬化患者132例。根据治疗方法不同分为对照组（n=51）和观察组（n=81）,门诊和电话随访5年,均行Child-Pugh评分和MELD评分,观察HBV DNA下降、阴转情况及肝功能指标,随访结束时对比两组临床结局。计量资料组间比较采用t检验,计数资料组间比较采用χ2检验。结果观察组肝癌、肝移植发生率及病死率均显著低于对照组（χ2值分别为4.32、4.33、4.71,P值均<0.001）;观察组治疗后HBV DNA载量显著低于同组治疗前（t=20.60,P<0.001）;观察组治疗后HBV DNA载量显著低于对照组治疗后（t=16.40,P<0.05）;观察组治疗后HBV DNA累积转阴率显著高于对照组（88.89%vs 6.67%,P<0.05）;观察组治疗后血清白蛋白水平显著高于对照组,TBil、ALT水平显著低于对照组（t值分别为6.77、16.60、11.67,P值均<0.001）;与治疗前比较...
- 肝硬化 /
- 治疗 /
- 预后
Abstract: Objective To investigate the effect of antiviral therapy on the long- term prognosis of patients with decompensated hepatitis B cirrhosis.Methods A total of 132 patients with decompensated hepatitis B cirrhosis who were hospitalized in The People's Hospital of Lezhi County 3 times or more from May 2009 to May 2012 were enrolled in the study.According to the therapies,the patients were divided into control group(51 patients) and observation group(81 patients).All the patients were followed up for 5 years via outpatient service and by telephone.Child- Pugh score and Model for End- Stage Liver Disease(MELD) score were obtained from all patients,and the reduction in HBV DNA,HBV DNA clearance,and liver function parameters were observed.Clinical outcomes were compared at the end of follow- up between the two groups.The t- test was used for comparison of continuous data between groups,and the chi- square test was used for comparison of categorical data between groups.Results The observation group had significantly lower incidence rate of liver cancer,rate of liver transplantation,and mortality rate than the control group(χ2= 4.32,4.33,and 4.71,all P < 0.001).After treatment,the observation group showed a significant reduction in HBV DNA level(t = 20.60,P < 0.001) and had a significantly lower HBV DNA level than the control group(t = 16.40,P < 0.05).After treatment,the observation group had a significantly higher cumulative clearance rate of HBV DNA than the control group(88.89% vs 6.67%,P < 0.05).After treatment,the observation group had a significantly higher serum albumin level and significantly lower levels of total bilirubin(TBil) and alanine aminotransferase(ALT) than the control group(t = 6.77,16.60,and 11.67,all P < 0.001),and both groups showed significant reductions in TBil and ALT after treatment(observation group:t = 25.18 and 23.33,both P < 0.001;control group:t = 6.15 and 7.20,both P < 0.001).The observation group showed a significant increase in serum albumin level after treatment(t = 10.08,P < 0.001).After treatment,the observation group had significantly lower Child- Pugh score and MELD score than the control group(t = 2.27 and 2.24,both P < 0.05),both groups showed significant reductions in Child- Pugh score and MELD score(observation group:t = 9.18 and 8.17,P < 0.001 and P = 0.03;control group:t = 2.93 and 3.12,P = 0.01 and0.04).Conclusion Long- term antiviral therapy can improve the long- term prognosis of patients with decompensated hepatitis B cirrhosis and increase the 5- year survival rate.
- liver cirrhosis /
- therapy /
- prognosis

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参考文献(15)

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