[1]付喜花,刘婉婷,娄海波,等.抗病毒药物治疗对乙型肝炎病毒相关慢加急性肝衰竭患者预后及血小板水平的影响[J].新乡医学院学报,2016,33(6):485-488.[doi:10.7683/xxyxyxb.2016.06.011]
 FU Xi-hua,LIU Wan-ting,LOU Hai-bo,et al.Influence of antiviral therapy on the platelet level and prognosis of patients with hepatitis B virus related acute-on-chronic liver failure[J].Journal of Xinxiang Medical University,2016,33(6):485-488.[doi:10.7683/xxyxyxb.2016.06.011]
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抗病毒药物治疗对乙型肝炎病毒相关慢加急性肝衰竭患者预后及血小板水平的影响
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
33
期数:
2016年6
页码:
485-488
栏目:
临床研究
出版日期:
2016-06-05

文章信息/Info

Title:
Influence of antiviral therapy on the platelet level and prognosis of patients with hepatitis B virus related acute-on-chronic liver failure
作者:
付喜花刘婉婷娄海波黄明寿吴文斌
(广州市番禺区中心医院感染科,广东 广州 511400)
Author(s):
FU Xi-huaLIU Wan-tingLOU Hai-boHUANG Ming-shouWU Wen-bin
(Department of Infectious Disease,Panyu District Central Hospital of Guangzhou City,Guangzhou 511400,Guangdong Province,China)
关键词:
乙型肝炎病毒慢加急性肝衰竭抗病毒药物血小板减少生存率
Keywords:
hepatitis B virusacute-on-chronic liver failureantiviral drugsthrombocytopeniasurvival rate
分类号:
R512.6
DOI:
10.7683/xxyxyxb.2016.06.011
文献标志码:
A
摘要:
目的 探讨抗病毒药物治疗对乙型肝炎病毒(HBV)相关慢加急性肝衰竭(ACLF)患者生存率及血小板水平的影响。方法 选择2007年9月至2014年12月广州市番禺区中心医院收治的HBV相关ACLF患者178例,其中63例患者给予基础治疗(对照组),115例患者给予基础治疗联合抗病毒药物治疗(观察组)。比较2组患者HBV DNA定量、国际标准化凝血比值(INR)、生存率及血小板计数(BPC)。结果 治疗前2组患者血清HBV DNA定量和INR比较差异均无统计学意义(P>0.05);观察组患者治疗12、24周时血清HBV DNA定量与INR均显著低于治疗前(P<0.01);治疗12、24周时,观察组患者血清HBV DNA定量和INR均显著低于对照组(P<0.01)。治疗24周末,对照组和观察组患者生存率分别为38.1%(24/63)和65.2%(75/115),观察组患者生存率显著高于对照组(P<0.05)。应用恩替卡韦、替比夫定及拉米夫定治疗患者的生存率比较差异均无统计学意义(P>0.05)。治疗前及治疗1、12周时,2组患者BPC比较差异均无统计学意义(P>0.05);治疗20、24周时,观察组患者BPC显著高于对照组(P<0.05,P<0.01)。结论 抗病毒药物治疗可改善HBV相关ACLF患者血小板水平,提高患者生存率。
Abstract:
Objective To investigate the influence of antiviral therapy on the platelet level and prognosis of patients with hepatitis B virus(HBV) related acute-on-chronic liver failure(ACLF).Methods A total of 178 patients with HBV related ACLF were selected in Panyu District Central Hospital of Guangzhou City from September 2007 to December 2014.Among the patients,63 patients(control group) were treated with basic treatment measures,115 patients(observation group) were treated with basic treatment measures and antiviral drugs.HBV DNA quantitation,international normalized ratio(INR),survival rate and blood platelets count(BPC) were compared between the two groups.Results There was no significant difference in the HBV DNA quantification and INR between the two groups before treatment(P>0.05).The HBV DNA quantification and INR at 12 and 24 weeks after treatment were significantly lower than those before treatment in observation group(P<0.01).The HBV DNA quantification and INR in observation group were significantly lower than those in control group at 12 and 24 weeks after treatment(P<0.01).The survival rate of the patients in control group and observation group was 38.1% (24/63) and 65.2% (75/115) respectively at 24 weeks after treatment,the survival rate in observation group was significantly higher than that in control group (P<0.05).There was no significant difference in the survival rate among the patients treated with entecavir,telbivudine or lamivudine(P>0.05).There was no significant difference in BPC between the two groups before treatment and 1 week,12 weeks after treatment(P>0.05).The BPC in observation group was significantly higher than that in control group at 20 and 24 weeks after treatment(P<0.05,P<0.01).Conclusion Antiviral therapy can improve the platelets level and survival rate in patients with HBV related ACLF.

参考文献/References:

[1] OLSON J C,KAMATH P S.Acute-on-chronic liver failure:concept,natural history,and prognosis[J].Curr Opin Crit Care,2011,17(2):165-169.
[2] 罗炳棋,向贤宏.肝硬化脾亢致血小板减少的影响因素与治疗选择[J].影像诊断与介入放射学,2010,19(6):373-376.
[3] BEHNAVA B,ALAVIAN S M,AHMADZAD A M.The prevalence of thrombocytopenia in patients with chronic hepatitis B and C[J].Hepat Mon,2006,6(2):67-69.
[4] SARIN S K,KUMAR A,ALMEIDA J A,et al.Acute-on-chronic liver failure:consensus recommendations of the Asian Pacific Association for the study of the liver(APASL)[J].Hepatol Int,2009,3(1):269-282.
[5] 张亚平,杨瑞,张光文.慢性乙型肝炎患者外周血T淋巴细胞受体谱型特征及其与干扰素抗病毒近期疗效的关系[J].新乡医学院学报,2014,31(3):195-198.
[6] 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.肝衰竭诊治指南:2012年版[J].实用肝脏病杂志,2013,16(3):210-216.
[7] 高海兵,林明华,潘晨,等.核苷类药物治疗HBV相关慢加急性肝衰竭患者24个月的生存分析[J].中华肝脏病杂志,2015,23(1):17-22.
[8] PHILIPS C A,SARIN S K.Potent antiviral therapy improves survival in acute on chronic liver failure due to hepatitis B virus reactivation[J].World J Gastroenterol,2014,20(43):16037-16052.
[9] 潘艳莎,贾苍松,陈婷婷.不同年龄免疫性血小板减少症患儿临床特点的对比分析[J].中华实用儿科临床杂志,2015,30(3):203-206.
[10] 占国清,谭华炳,李儒贵,等.慢性乙型肝炎患者凝血功能和血小板参数检测结果分析[J].实用肝脏病杂志,2011,4(6):412-414.
[11] 施士宇.慢性乙型病毒性肝炎合并骨髓抑制3例[J].世界华人消化杂志,2008,16(9):1024-1025.
[12] 周建尧,单平囡,王玲子,等.肝硬化患者血清血小板生成素水平的测定及临床意义[J].临床肝胆病杂志,2006,22(2):114-115.
[13] GANGIREDDY V G R,KANNEGANTI P C,SRIDHAR S,et al.Management of thrombocytopenia in advanced liver disease[J].Can J Gastroenterol Hepatol,2014,28(10):558-564.

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更新日期/Last Update: 2016-06-05