拉米夫定在慢性乙型肝炎引起的慢加急性肝衰竭中的疗效和安全性分析

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目的:探讨拉米夫定治疗慢性乙型肝炎而引起的慢加急性肝衰竭临床治疗效果。方法:将选取的60例慢性乙型肝炎而引起的慢加急性肝衰竭患者按照入院的先后顺序随机的分为两组,对照组给予常规治疗,实验组在常规治疗基础上给予拉米夫定治疗,观察两组的临床治疗效果。结果:实验组的好转率为56.7%,对照组的好转率为40.0%,两组的数据比较具有明显的差异(P<0.05),有统计学意义;实验组的死亡率明显低于对照组的情况,差异有统计学意义(P<0.05);实验组与对照组患者治疗前的TBil、ALT、ALB、AST、PTA和HBV-DNA比较无明显的差异(P>0.05),无统计学意义;治疗后实验组与对照组的TBil、ALB和AST以及PTA与HBVDNA的比较具有明显的差异,有统计学意义(P<0.05)。而治疗后实验组和对照组的ALT含量比较无明显的差异(P>0.05),无统计学意义。约3年的随访观察,对照组5例生存,2例失访,另外23例对死亡,3年后生存率为16.7%;实验组11例生存,无1例发生失访,19例患者死亡,3年后生存率为36.7%。实验组的生存率明显的高于对照组的生存率,两组的数据比较具有明显的差异(P<0.05),有统计学意义。结论:临床中慢性乙型肝炎而引起的慢加急性肝衰竭患者给予拉米夫定治疗具有较好的应用效果,提高患者的临床效率,并降低死亡的情况发生。同时,有效的改善患者的肝功能,促进肝脏的代谢,改善预后。 Objective: To investigate the clinical efficacy of lamivudine in the treatment of chronic hepatitis B and chronic and acute liver failure. Methods: Sixty chronic hepatitis B patients with acute and chronic acute liver failure were randomly divided into two groups according to the order of admission. The control group was given routine treatment. The experimental group was given lamivudine on the basis of routine treatment Treatment, observe the clinical treatment effect of two groups. Results: The improvement rate of the experimental group was 56.7%, the improvement rate of the control group was 40.0%, there was significant difference between the two groups (P <0.05), the difference was statistically significant; the mortality of the experimental group was significantly lower than that of the control group (P <0.05). There was no significant difference in TBil, ALT, ALB, AST, PTA and HBV-DNA between the experimental group and the control group before treatment (P> 0.05), and no statistical difference Significance; TBil, ALB and AST, PTA and HBVDNA in experimental group and control group after treatment were significantly different, with statistical significance (P <0.05). There was no significant difference in ALT content between the experimental group and the control group after treatment (P> 0.05), but there was no statistical significance. About 3 years of follow-up observation, 5 cases in the control group survived, 2 cases were lost to follow-up, and the other 23 cases died. The survival rate after 3 years was 16.7%. In the experimental group, 11 cases survived. , 3 years after the survival rate was 36.7%. The survival rate of the experimental group was significantly higher than that of the control group, the two groups of data showed significant differences (P <0.05), with statistical significance. Conclusion: Lamivudine treatment is effective in patients with chronic and acute liver failure caused by chronic hepatitis B in clinical practice, which improves the clinical efficiency and reduces the death of patients. At the same time, effectively improve the patient’s liver function, promote liver metabolism, improve prognosis.
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