血浆置换联合恩替卡韦治疗高原地区乙型慢加急性肝衰竭的疗效分析

目的：分析血浆置换联合恩替卡韦治疗高原地区乙型慢加急性肝衰竭的疗效。方法：将127例乙型慢加急性肝衰竭患者随机分4组：常规内科治疗组、恩替卡韦治疗组、血浆置换治疗组、血浆置换联合恩替卡韦治疗组,分析4组治疗前后血清谷丙转氨酶（ALT）、血清总胆红素（TBIL）、血清白蛋白（ALB）、凝血酶原活动度（PTA）、HBV-DNA等变化情况及患者治疗有效率。结果：血浆置换联合恩替卡韦治疗组患者的谷丙转氨酶、血清总胆红素均明显下降,血清白蛋白及凝血酶原活动度均显著提高,HBV-DNA阴转率高,患者治疗有效率高。结论：血浆置换联合恩替卡韦能有效改善高原地区乙型慢加急性肝衰竭患者的生化指标,促进HBV-DNA阴转,提高临床有效率,防止因高原低氧环境导致的肝衰竭进一步加重,获得最佳疗效,改善患者预后,是高原地区治疗乙型慢加急性肝衰竭的一种安全有效的方法。

Treatment Effects of Plasma Exchange Combined Entecavir on Acute -on -chronic Liver Failure Hepatitis B- Induced at High Altitude

Objective： To compare treatment effect of different therapy on acute - on - chronic liver failure hepatitis B - induced at high altitude. Methods： 127 cases of hepatitis B patients with acute on chronic hepatic failure randomLy divided into four groups： conventional medical treatment group （ group A）, entecavir treatment group （group B）, plasma exchange treatment group （group C）, and plasma exchange combined entecavir treatment group （ group D）. Serum levels of ALT, TBIL, ALB, PTA, HBV - DNA and the effective rate of treatment were detected and analyzed before and after treatment in the four groups. Results： As compared with group A, B and C, in the group D, level of ALT and TBIL were significantly decreased; ALB and PTA level were significantly in- creased; HBV - DNA negative change rate was higher and the effective rate of treatment increased. Condusions： Plasma exchange combined entecavir therapy is a safe and effective method that can effectively improve the biochemical indices in patients with acute on chronic hepatic failure hepatitis B -induced, and can promote HBV - DNA seroconversion.