免疫治疗对重型肝炎与肝炎后肝硬化合并感染的临床疗效观察(1)
[摘要] 目的 探討免疫治疗对重型肝炎与肝炎后肝硬化合并感染的临床疗效。 方法 将2016年4月～2018年4月在我院消化内科治疗的84例重型肝炎与肝炎后肝硬化合并感染患者随机分为两组，对照组采用常规保肝、抗感染及对症支持治疗，在此基础上观察组使用免疫制剂治疗，比较两组患者的感染控制效果、炎性因子水平变化、肝功能各指标变化、疾病转归。 结果 观察组感染控制率为88.10%，明显高于对照组的61.90%(P<0.05);观察组治疗后CRP、WBC、PCT、TNF-α水平均明显低于对照组(P<0.05);观察组治疗后总胆红素、丙氨酸氨基转移酶、白蛋白、凝血酶原时间、总胆固醇与对照组相比无明显差异(P>0.05)，但两组治疗后较治疗前各指标明显下降(P<0.05);观察组上消化道出血、肝肾综合征、肝性脑病、死亡等发生率均明显低于对照组(P<0.05)。 结论 重型肝炎与肝炎后肝硬化合并感染在常规抗感染、保肝等治疗基础上使用免疫制剂，可有效提升疗效，促进炎症消退，保护肝功能，降低并发症发生率及死亡率。
[关键词] 重型肝炎;肝炎后肝硬化;感染;免疫制剂;临床疗效
[中图分类号] R575 [文献标识码] B [文章编号] 1673-9701(2019)03-0034-03
[Abstract] Objective To investigate the clinical efficacy of immunotherapy for severe hepatitis and post-hepatitic cirrhosis with infection. Methods 84 patients with severe hepatitis and post-hepatitis cirrhosis who were treated in the department of gastroenterology of our hospital from April 2016 to April 2018 were randomly divided into two groups. The control group received routine liver protection， anti-infection and symptomatic supportive treatment. On this basis， the observation group was treated with immunological agents. The infection control effect， the change of inflammatory factors， the change of liver function indexes， and the disease outcome were compared between the two groups. Results The infection control rate of the observation group was 88.10%， which was significantly higher than that of the control group(61.90%). The levels of CRP， WBC， PCT and TNF-α in the observation group were significantly lower than those in the control group(P<0.05). There was no significant difference in total bilirubin， alanine aminotransferase， albumin， prothrombin time and total cholesterol between the observation group and the control group(P>0.05). But the indexes of the two groups after treatment were decreased significantly(P<0.05). The incidence of upper gastrointestinal hemorrhage， hepatorenal syndrome， hepatic encephalopathy and death in the observation group were significantly lower than those in the control group(P<0.05). Conclusion The use of immunological preparations on the basis of conventional anti-infective， liver-protecting and other treatments for severe hepatitis and post-hepatitis cirrhosis can effectively improve the efficacy， promote inflammation， protect liver function， and reduce the incidence of complications and mortality.
[Key words] Severe hepatitis; Post-hepatitis cirrhosis; Infection; Immune preparation; Clinical efficacy, 百拇医药(许婷婷)
[关键词] 重型肝炎;肝炎后肝硬化;感染;免疫制剂;临床疗效
[中图分类号] R575 [文献标识码] B [文章编号] 1673-9701(2019)03-0034-03
[Abstract] Objective To investigate the clinical efficacy of immunotherapy for severe hepatitis and post-hepatitic cirrhosis with infection. Methods 84 patients with severe hepatitis and post-hepatitis cirrhosis who were treated in the department of gastroenterology of our hospital from April 2016 to April 2018 were randomly divided into two groups. The control group received routine liver protection， anti-infection and symptomatic supportive treatment. On this basis， the observation group was treated with immunological agents. The infection control effect， the change of inflammatory factors， the change of liver function indexes， and the disease outcome were compared between the two groups. Results The infection control rate of the observation group was 88.10%， which was significantly higher than that of the control group(61.90%). The levels of CRP， WBC， PCT and TNF-α in the observation group were significantly lower than those in the control group(P<0.05). There was no significant difference in total bilirubin， alanine aminotransferase， albumin， prothrombin time and total cholesterol between the observation group and the control group(P>0.05). But the indexes of the two groups after treatment were decreased significantly(P<0.05). The incidence of upper gastrointestinal hemorrhage， hepatorenal syndrome， hepatic encephalopathy and death in the observation group were significantly lower than those in the control group(P<0.05). Conclusion The use of immunological preparations on the basis of conventional anti-infective， liver-protecting and other treatments for severe hepatitis and post-hepatitis cirrhosis can effectively improve the efficacy， promote inflammation， protect liver function， and reduce the incidence of complications and mortality.
[Key words] Severe hepatitis; Post-hepatitis cirrhosis; Infection; Immune preparation; Clinical efficacy, 百拇医药(许婷婷)