慢性乙型病毒性肝炎伴胆道病变的临床抗感染治疗策略

目的 探讨慢性乙型病毒性肝炎胆道病变患者的抗感染用药方法。方法 选取慢性乙型病毒性肝炎伴胆道病变的患者160例。在护肝治疗的基础上进行抗生素或者曲匹布通治疗。观察临床体征和肝功能相关指标的变化，并观察药物性肝损害的出现。结果 四组患者接受治疗前，肝功能具有可比性。经过护肝治疗和抗生素或曲匹布通治疗后，肝功能均有所好转，胆道病变有所改善。在各组治疗后，TBIL、ALT、AST、AKP、TBA、GGT、LDH均较治疗前有改善，其中，A、C组较B、D组肝功能恢复较好，B、D组之间无显著差异，C组在四组当中，肝功能恢复最佳。结论 慢性乙型病毒性肝炎伴胆道病变原因复杂，可能存在细菌和梗塞相互影响促进。进行抗生素联合曲匹布通治疗可以较好的缓解病情，有助于肝功能恢复。

Strategy of Anti-Infective Treatment for Patients with Chronic Hepatitis B Combined with Biliary Disease

Objective To investigate the anti-infection treatment for patients with chronic viral hepatitis combined with biliary disease. Methods 160 chronic hepatitis B patients with biliary tract disease were chosen to have liver protection treatment on the basis of antibiotics or Trepibutone therapy. The clinical signs and changes of liver function indicators were examined, and the emergence of drug-induced liver injury was recorded. Results Patients before receiving treatment, liver function were comparable to the control group. After liver protection treatment with antibiotics or Trepibutone, both the liver function and biliary disease have improved. Conclusion Chronic hepatitis B with biliary lesions had complex causes. Bacterial infection may worsen infarction. Antibiotic and Trepibutone therapy can be used to ease the condition and helD liver function recovering.