膦甲酸钠治疗慢性重型乙型肝炎的临床观察

目的探讨膦甲酸钠治疗慢性重型乙型肝炎的疗效及其不良反应。方法选择慢性重型乙型肝炎患者80例，将其随机分为2组，对照组40例仅给予常规护肝及支持治疗，治疗组40例在常规护肝及支持治疗的基础上加用膦甲酸钠3．0g静滴，疗程4周，治疗前后检测肝功能、凝血酶原活动度、乙型肝炎病毒复制标志物HBV DNA和HBeAg，同时观察患者的症状、体征的变化及药物的不良反应。结果HBeAg滴度、HBV DNA拷贝数下降水平治疗组明显高于对照组，差异有显著性（P〈0．05）；HBeAg、HBV DNA的转阴率治疗组明显高于对照组，差异有显著性（P〈0．05）。治疗结束后AST、ALT、TBil治疗组明显低于对照组，差异有显著性（P〈0．05），PTA上升治疗组明显高于对照组，差异也有显著性（P〈0．05）。病死率治疗组明显低于对照组，差异有显著性（P〈0．05）。膦甲酸钠的不良反应主要是轻度的胃肠道反应。结论膦甲酸钠对乙型肝炎病毒有确切的抑制作用，对慢性重型乙型肝炎的治疗具有促进肝功能恢复，降低病死率等优点，膦甲酸钠无明显的不良反应，耐受性较好。

Clinical effect of foscarnet sodium in patients with chronic severe hepatitis B

Objective] To observe the clinical effect and adverse effect of foscarnet sodium in treating patients with chronic severe hepatitis B.Methods] 80 patients with chronic severe hepatitis B were randomly divided into two groups,the control group(n=40) was only received liver-protective drugs and supportive therapy,while the treatment group(n=40) was administrated foscarnet sodium plus liver-protective drugs and supportive therapy for 4 weeks.Liver function,prothrombin activity(PTA),HBV replication marks such as HBeAg and HBV DNA were detected before and after treatment.The symptom,physical sign and adverse effect were observed.Results] The titer of HBeAg and copies of HBV DNA in the treatment group were significantly lower than those in the control group(P <0.05);the HBV replication markers negative-conversion rate was significantly different between the control group and the treatment group(P <0.05);the levels of AST,ALT and TBil were significantly lower in the treatment group than those in the control group(P <0.05);the level of PTA in the treatment group was significantly higher than that in the control group(P <0.05),while the mortality in the treatment group was significantly lower than that in the control group(P<0.05).The adverse reaction was only mild gastrointestinal reaction.Conclusion] Foscarnet sodium can inhabit HBV replication and improve liver function.It has beneficial therapeutic effect on chronic severe hepatitis B and can decrease mortality.Foscarnet sodium has no transparent adverse effect and it is a safe antivirus drug.