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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:

33

期数:

2016年11

页码:

993-995

栏目:

临床研究

出版日期:

2016-11-05

文章信息/Info

Title:

Influencing factors for the effect of plasma exchange in treatment of patients with chronic severe hepatitis B

作者:

汪　艳; 陈　乐

（黄冈市中心医院感染科，湖北　黄冈　438000）

Author(s):

WANG Yan; CHEN Le

（Department of Infectious Diseases,Huanggang Central Hospital,Huanggang 438000,Hubei Province,China）

关键词:

血浆置换; 慢性重型乙型肝炎; 肝功能; 肾功能

Keywords:

plasma exchange; chronic severe hepatitis B; liver function; renal function

分类号:

R512.6⁺2

DOI:

10.7683/xxyxyxb.2016.11.016

文献标志码:

A

摘要:

目的　探讨血浆置换（PE）治疗慢性重型乙型肝炎的疗效及其影响因素。方法　选取2010年1月至2013年7月黄冈市中心医院收治的慢性重型乙型肝炎患者196例，根据治疗方法分为观察组124例和对照组72例。对照组患者给予常规综合内科治疗，观察组患者在常规综合内科治疗的基础上给予PE治疗；比较2组患者在临床疗效、肝功能及肾功能，并分析影响疗效的相关因素。结果　观察组和对照组患者治疗有效率分别为83.87%（104/124）和51.39％（37/72），观察组患者治疗有效率显著高于对照组（P<0.05）。治疗前2组患者血清总胆红素（TBIL）、总胆固醇（TC）、白蛋白（ALB）、凝血酶原活性（PTA）、丙氨酸氨基转移酶（ALT）、胆碱酯酶（CHE）水平比较差异均无统计学意义（P>0.05）。治疗后观察组患者ALT、TBIL水平显著低于治疗前（P<0.05），TC、ALB、PTA、CHE水平显著高于治疗前（P<0.05）。治疗后对照组患者ALT、TBIL水平显著低于治疗前（P<0.05），ALB水平显著高于治疗前（P<0.05）；对照组患者治疗前后TC、PTA、CHE水平比较差异均无统计学意义（P>0.05）。治疗后观察组患者ALT、TBIL水平显著低于对照组（P<0.05），ALB、TC、PTA、CHE水平显著高于对照组（P<0.05）。治疗前2组患者血肌酐（SCr）、血尿素氮（BUN）水平比较差异均无统计学意义（P>0.05）。观察组患者治疗后SCr、BUN水平显著低于治疗前（P<0.05），对照组患者治疗前后SCr、BUN水平比较差异均无统计学意义（P>0.05）。治疗后观察组患者SCr、BUN水平显著低于对照组（P<0.05）。患者年龄、肝炎临床分期、肝硬化及PTA是PE治疗慢性重型乙型肝炎疗效的影响因素（P<0.05）。结论　PE治疗慢性重型乙型肝炎安全有效，可显著改善慢性重型乙型肝炎患者的肝、肾功能；患者年龄、肝硬化、肝炎临床分期和PTA是影响PE治疗慢性重型乙型肝炎疗效的相关因素。

Abstract:

Objective　To investigate the influencing factors for the effect of plasma exchange(PE) in treatment of patients with chronic severe hepatitis B.Methods　A total of 196 patients with chronic severe hepatitis B were selected in Huanggang Central Hospital from January 2010 to July 2013.The patients were divided into observation group(n=124) and control group(n=72) according to therapeutic method.The patients in control group were treated with routine comprehensive medical treatment,the patients in observation group were treated with PE treatment on the basis of conventional treatment.The clinical effect,liver function and renal function were compared between the two groups,and the related factors affecting the therapeutic effect were analyzed.Results　The effective rate of in observation group and control group was 83.87% (104/124) and 51.39% (37/72) respectively,the effective rate in observation group was significantly higher than that in control group (P<0.05).There was no significant difference in the levels of serum total bilirubin (TBIL),total cholesterol(TC),albumin(ALB),prothrombin activity (PTA),alanine aminotransferase(ALT),cholinesterase (CHE) between the two groups before treatment (P>0.05).The levels of ALT and TBIL after treatment were significantly lower than those before treatment (P<0.05),and the levels of TC,ALB,PTA and CHE after treatment were significantly higher than those before treatment in observation group(P<0.05).The levels of ALT and TBIL after treatment were significantly lower than those before treatment (P<0.05),and the level of ALB after treatment was significantly higher than that before treatment (P<0.05),but there was no significant difference in the levels of TC,PTA and CHE before and after treatment in observation group(P>0.05).The levels of ALT and TBIL in observation group were significantly lower than those in control group (P<0.05),and the levels of ALB,TC,PTA and CHE in observation group were significantly higher than those in control group after treatment(P<0.05).There was no significant difference in the levels of serum creatinine (SCr) and blood urea nitrogen (BUN) between the two groups before treatment (P>0.05).The levels of SCr and BUN after treatment were significantly lower than those before treatment in observation group (P<0.05).There was no significant difference in the levels of SCr and BUN before and after treatment in control group(P>0.05).The levels of SCr and BUN in observation group were significantly lower than those in control group after treatment (P<0.05).Age,clinical stage of hepatitis,liver cirrhosis and PTA were the influencing factors for the effect of PE in the treatment of chronic severe hepatitis B(P<0.05).Conclusion　PE is safe and effective in the treatment of chronic severe hepatitis B,which can significantly improve the liver and renal function of patients.Age,liver cirrhosis,clinical stage of hepatitis and PTA are the related factors affecting the effect of PE on chronic severe hepatitis B.

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更新日期/Last Update: 2016-11-05