小剂量激素治疗慢加急性肝衰竭或重症倾向肝炎的效果及安全性

石协桐 钟少龙 许金微

[摘要] 目的 探讨小剂量激素治疗慢加急性肝衰竭或重症倾向肝炎的效果及安全性。 方法 选取2019年7月至2020年5月我院治疗的慢加急性肝衰竭或重症倾向肝炎患者60例进行研究，按照不同的治疗方法分为对照组和观察组。对照组29例患者采用抗病毒、护肝、营养支持等综合治疗;观察组31例患者在综合治疗的基础上联合短期小剂量糖皮质激素治疗。比较两组患者的治疗总有效率、各项临床症状评分及安全问题总发生率。 结果 经过治疗后，观察组患者的治疗总有效率明显高于对照组，差异有统计学意义（P<0.01）;观察组患者各项临床症状评分明显低于对照组，差异均有统计学意义（P<0.05）;观察组患者的安全问题总发生率为25.81%，低于对照组的72.41%，差异有统计学意义（P<0.05）。 结论 对慢加急性肝衰竭或重症倾向肝炎患者采用常规综合治疗联合短期小剂量糖皮质激素治疗，能有效提高患者的治疗总有效率，显著降低患者的各项临床症状评分及安全问题总发生率。

[关键词] 小剂量;糖皮质激素;慢加急性肝衰竭;重症倾向肝炎;治疗效果;安全性评估

[Abstract] Objective To investigate the efficacy and safety of low-dose hormone in the treatment of acute-on-chronic liver failure or severe tendency hepatitis. Methods From July 2019 to May 2020， 60 patients with acute-on-chronic liver failure or severe tendency hepatitis admitted to our hospital were selected， and they were divided into the control group（n=29） and the observation group（n=31） by different treatment methods adopted. The patients in the control group were treated with comprehensive treatment such as antivirus， liver protection and nutritional support， while the patients in the observation group were treated with short-term low-dose glucocorticoid on the basis of comprehensive treatment. The overall treatment efficacies， the scores of various clinical symptoms and total incidence of safety incidents of the two groups were observed. Results After treatment， the overall treatment efficacies in the observation group was significantly higher than that in the control group， with statistically significant difference（P<0.01）. The scores of various clinical symptoms in the observation group were significantly lower than those in the control group， with statistically significant differences（P<0.05）. The total incidence of safety incidents in the observation group was 25.81%， which was lower than 72.41% in the control group， with statistically significant difference（P<0.05）. Conclusion By adopting routine medical treatment combined with short-term low-dose glucocorticoid treatment for patients on acute-on-chronic liver failure or severe tendency hepatitis， the overall treatment efficiency of patients was effectively improved， the scores of various clinical symptoms of patients were significantly reduced， and total incidence of safety incidents was decreased.

[Key words] Low-dose; Glucocorticoid; Acute-on-chronic liver failure; Severe tendency hepatitis; Treatment efficacy; Safety assessment

慢加急性肝衰竭或重症倾向肝炎属临床急性损伤性疾病，会在短时间内导致患者死亡。其病理发展过程是患者体内大量肝细胞坏死，产生严重变性，从而导致肝功能衰竭[1]。由于该病进展快、症状表现突出，并且具有较多的并发症，患者多因器官衰竭而死亡，死亡率極高。肝衰竭引起的细胞坏死激活补体系统，引起微循环障碍，导致患者肝细胞缺血、缺氧，进而发生感染和毒素吸收增加，刺激炎症因子释放。为探讨小剂量激素治疗慢加急性肝衰竭或重症倾向肝炎的效果及安全性，本研究选取慢加急性肝衰竭或重症倾向肝炎患者60例进行研究，现报道如下。

1 资料与方法

1.1 一般资料

选取2019年7月至2020年5月我院治疗的慢加急性肝衰竭或重症倾向肝炎患者60例进行研究，按照不同治疗方法分为对照组和观察组，对照组29例患者采用抗病毒、护肝、营养支持等综合治疗，观察组31例患者在综合治疗的基础上联合短期小剂量糖皮质激素治疗。……