血浆置换联合抗病毒治疗慢性重型肝炎早期30例临床观察

目的：观察血浆置换联合恩替卡韦治疗慢性重型肝炎的疗效。方法：将慢性重型肝炎患者62例随机分为观察组30例和对照组32例,两组均给予保肝、利尿、降低门脉压、补充蛋白及抗菌药物等内科综合治疗,观察组在此基础上行人工肝（血浆置换）治疗1～3次,同时口服恩替卡韦片0.5 mg,每日1次。治疗4周后观察两组临床疗效,包括临床症状、体征、肝功能、凝血酶原活动度（PTA）、HBV-DNA定量的变化情况。结果：观察组的总有效率73.3%（22/30）高于对照组的43.8%（14/32）（χ2=5.74,P〈0.05）。观察组在临床症状、体征、凝血酶原活动度（PTA）、HBV-DNA定量、肝功能改善方面与对照组差异有统计学意义（t=2.42;6.46;2.56,P〈0.05）。结论：血浆置换联合恩替卡韦治疗慢性重型肝炎可加快肝功能好转,快速抑制病毒复制,提高生存率,具有肯定的治疗作用。

Plasma exchange combined with anti-viral treatment of 30 cases of chronic severe hepatitis

Objective：To observe the plasma exchange combined with entecavir treatment of chronic severe hepatitis.Methods：62 patients with chronic severe hepatitis were randomly divided into study group（30 cases） and control group（32 cases）,all hepatitis were given hepatoprotective,diuretic,reduces portal pressure,added protein and comprehensive treatment of antibiotics and other medical;Based on these,observation group hepatitis take artificial liver（plasma exchange） therapy 1～3 times while taken orally entecavir tablets 0.5 mg each time,one time a day.Clinical observation（including clinical symptoms and signs,liver function,prothrombin activitymm,HBV-DNA quantitative changes） were observed after 4 weeks of treatment in all hepatitis.Results：The total effective rate of observation group 73.3%（22/30） was significantly higher than that of control group 43.8%（14/32）（χ2=5.74,P〈0.05）.There was significant difference of clinical symptoms,signs,prothrombin activity（PTA）,HBV-DNA quantification,the liver function improvement,between observation group and the control group（t=2.42;6.46;2.56,P〈0.05）.Conclusion：Plasma exchange combined with entecavir for chronic hepatitis can speed up the improvement of liver function,rapid inhibition of viral replication and improve survival,with a positive therapeutic effect.