[1]王会敏,韩际奥",徐于平,等.利福昔明治疗乙型肝炎肝硬化腹水疗效观察[J].新乡医学院学报,2021,38(9):842-845.[doi:10.7683/xxyxyxb.2021.09.009]
 WANG Huimin,HAN Jiao,XU Yuping,et al.Curative effect of rifaximin in the treatment of hepatitis B related cirrhosis and ascites[J].Journal of Xinxiang Medical University,2021,38(9):842-845.[doi:10.7683/xxyxyxb.2021.09.009]
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利福昔明治疗乙型肝炎肝硬化腹水疗效观察
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
38
期数:
2021年9
页码:
842-845
栏目:
临床研究
出版日期:
2021-09-05

文章信息/Info

Title:
Curative effect of rifaximin in the treatment of hepatitis B related cirrhosis and ascites
作者:
王会敏1韩际奥"12徐于平2马英杰12刘璨宇1
(1.新乡医学院研究生院,河南 新乡 453003;2.郑州人民医院消化内科,河南 郑州 450000)
Author(s):
WANG Huimin1HAN Ji′ao12XU Yuping2MA Yingjie12LIU Canyu1
(1.School of Graduate,Xinxiang Medical University,Xinxiang 453003,Henan Province,China2.Department of Gastroenterology,Zhengzhou People′s Hospital,Zhengzhou 450000,Henan Province,China)
关键词:
利福昔明乙型肝炎肝硬化腹水小肠细菌过度生长
Keywords:
rifaximinhepatitis Bcirrhosisascitessmall intestine bacterial overgrowth
分类号:
R575.2
DOI:
10.7683/xxyxyxb.2021.09.009
文献标志码:
A
摘要:
目的 探讨利福昔明治疗乙型肝炎肝硬化腹水的临床效果。方法 选择2018年9月至2020年1月郑州人民医院消化内科收治的乙型肝炎肝硬化腹水患者70例为研究对象。根据治疗方式将患者分为对照组和观察组,每组35例。对照组患者给予恩替卡韦(口服,0.5 mg,每日1次,共治疗180 d)、异甘草酸镁注射液(静脉滴注,200 mg,每日1次,共治疗 14 d)、呋塞米片(口服,40 mg,每日1次,共治疗14 d)、螺内酯片(口服,100 mg,每日1次,共治疗 14 d)治疗。在对照组治疗方案基础上,观察组患者给予利福昔明(每个疗程连续口服3 d,每日3次,每次400 mg,14 d为1个疗程,共12个疗程)治疗。分别于治疗前和治疗6个月后检测所有患者的体质量、腹围和24 h尿量。分别于治疗前和治疗6个月后采用彩色多普勒超声测定患者腹水量,并进行腹水量分级。分别于治疗前和治疗6个月后,采用氢呼气试验检测所有患者小肠细菌过度生长(SIBO)情况。结果 治疗前2组患者的体质量、腹围、24 h 尿量比较差异无统计学意义(P>0.05)。治疗6个月后,2组患者的体质量、腹围显著低于治疗前,24 h 尿量显著高于治疗前(P<0.05);观察组患者的体质量、腹围显著低于对照组,24 h 尿量显著高于对照组(P<0.05)。治疗前2组患者的腹水分级比较差异无统计学意义(Z=-0.721,P>0.05)。治疗6个月后,对照组和观察组患者的腹水分级与治疗前比较差异有统计学意义(Z=-2.124、-4.021,P<0.05);观察组患者的腹水分级与对照组比较差异有统计学意义(Z=-2.447,P<0.05)。治疗前对照组和观察组患者的SIBO阳性率分别为54.29%(19/35)、45.71%(16/35);治疗6个月后,对照组和观察组患者的SIBO阳性率分别为22.9%(13/35)、8.6%(4/35)。治疗前,2组患者的SIBO阳性率比较差异无统计学意义(χ2= 0.514,P>0.05)。治疗6个月后,2组患者的SIBO阳性率均显著低于治疗前(χ2=-2.236、-3.464,P<0.05);观察组患者的SIBO阳性率显著低于对照组(χ2=11.822,P<0.05)。结论 利福昔明可降低乙型肝炎肝硬化腹水患者的腹水量和SIBO阳性率。
Abstract:
Objective To investigate the clinical efficacy of rifaximin in the treatment of hepatitis B related cirrhosis and ascites.Methods Seventy patients with hepatitis B related cirrhosis and ascites admitted to the Department of Gastroenterology of Zhengzhou People′s Hospital from September 2018 to January 2020 were selected as study subjects.According to the treatment methods,the patients were divided into control group and observation group,with 35 cases in each group.Patients in the control group took entecavir 0.5 mg (oral,once daily for 180 d),magnesium isoglycyrrhizinate injection 200 mg (intravenous drip,once daily for 14 d),furosemide tablets 40 mg (oral,once daily for 14 d),spironolactone tablets 100 mg (oral,once daily for 14 d).Based on the treatment regimen of the control group,the patients in the observation group were given rifaximin 400 mg (each course of treatment was administered orally for 3 d,3 times a day,14 d was a course of treatment,a total of 12 courses).Before treatment and 6 months after treatment,the body weight,abdominal circumference and 24-hour urine volume of all patients were measured.The abdominal water volume was measured by color Doppler ultrasound before treatment and 6 months after treatment,and the abdominal water volume was graded.The small intestinal bacterial overgrowth(SIBO) status of all patients was detected by hydrogen breath test before and after 6 months of treatment,respectively.Results There was no statistically significant difference in the body weight,abdominal circumference and 24-hour urine volume of patients between the two groups before treatment (P>0.05).After 6 months of treatment,the body weight and abdominal circumference of patients were significantly lower than those before treatment,and the 24-hour urine volume was significantly higher than that before treatment in the two groups (P<0.05)the body weight and abdominal circumference of patients in the observation group were significantly lower than those in the control group,and the 24-hour urine volume was significantly higher than that in the control group (P<0.05).There was no statistically significant difference in ascites grading of patients between the two groups before treatment (Z=-0.721,P>0.05)there was a statistically significant difference in ascites grading of patients before and after 6 months of treatment in the two groups(Z=-2.124,-4.021P<0.05)after 6 months of treatment,there was a statistically significant difference in ascites grading of patients between the observation group and the control group (Z=-2.447,P<0.05).Before treatment,the positive rates of SIBO of patients in the control group and observation group were 54.29% (19/35) and 45.71% (16/35),respectivelyafter 6 months of treatment,the positive rates of SIBO of patients in the control group and observation group were 22.9% (13/35) and 8.6% (4/35),respectively.There was no significant difference in the positive rates of SIBO between the two groups before treatment (χ2= 0.514,P>0.05)after 6 months of treatment,the positive rates of SIBO of patients in the two groups were significantly lower than those before treatment (Z=-2.236,-3.464P<0.05)after 6 months of treatment,the SIBO positive rate of patients in the observation group was significantly lower than that in the control group (χ2=11.822,P<0.05).Conclusion Rifaximin can reduce the amount of ascites of patients with hepatitis B related cirrhosis and ascites and the positive rate of SIBO.

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更新日期/Last Update: 2021-09-05