人免疫球蛋白治疗终末期肝病合并感染临床观察

目的:观察静脉注射人免疫球蛋白(immunoglobulin,IG)治疗终末期肝病合并感染的疗效。方法:将105例终末期肝病合并感染患者随机分为治疗组53例和对照组52例,对照组应用抗生素等常规治疗,治疗组加用IG,根据Child-Pugh评分分层观察治疗效果。结果:Child-Pugh < 10分患者,2组感染1周后均有胆红素升高、胆固醇下降、凝血酶原时间延长,2组治疗1周感染控制有效率差异无统计学意义(P>0.05)。Child-Pugh 10~15分患者,治疗组和对照组感染有效率分别为80.00%和46.15%,无效率为20.00%和53.85%(P<0.05)。结论:对Child-Pugh评分10~15分的终末期肝病合并感染患者,早期联合应用IG治疗能提高抗感染的疗效,可能有助于减少二重霉菌感染的发生。

Effect of immunoglobulin on end stage liver disease combined with infection

Objective：To explore the effect of immunoglobulin（IG） on patients with end stage liver diseases combined with infection.Methods：One hundred and five patients with end stage liver diseases combined with infection were randomized into treatment group（53 cases） and control group（52 cases）.The control group received the routine therapy of antibiotics and the treatment group were administered IG in addition to the antibiotics.The clinical effect was evaluated according to the Child-Pugh score.Results：The patients with the score of Child-Pugh10 in the two groups presented increased total bilirubin,decreased cholesterol and prolonged prothrombin time after one week′s therapy,and there were no significant differences between the two groups.In patients with the score of Child-Pugh 10-15,the percentage of efficiency was 80.00% and 46.15%（P0.05） in the study group and the control group respectively,and the percentage of inefficiency was 20.00% and 53.85%（P0.05）.Conclusions：Early therapy of IG can effectively increase the anti-infection ability of patients with end stage liver diseases combined with infection whose score of Child-Pugh is 10-15,and may help to reduce the mycotic double infection.