•临床研究论著・抗病毒治疗对慢性乙型肝炎肝衰竭1年的疗效何纲I,沛林2,丁佩佩「陈晓华I,梁少群I,血月（1.广东省江门市中心医院感染科•广东江门529030；2・广东市中心医院科教科，广529030摘耍:FI的为抗病W物治疗（探讨抗病毒治疗对慢性乙型肝炎肝衰财的1年疗效。方法收集慢性治疗组，选取历史病例67例为对照组。抗病毒治疗纽在拉米炎肝衰财病例，选取54科治疗的基础上加用抗夫定、恩祎卡韦、替比夫定）,对照组仅使用内科常规治疗。分析两纽.患者在不同时间点病死；DNA水平.INR、MELD评分及肝功能结果。结果治疗1个月后，两纽死亡率差异无统计学意义（P>0.05）o治疗3个月病毒治疗组死亡15例（27.8%）,显著低于对照组（32例，47.8%）,差异有统计学意义（PV0.05）。治疗1年毒治疗纽死亡15例（27.8%）,显著低于对照组（37例，61.7%）,差异有统计学意义（P<0.05）。治疗1个月后，两组患AST.TBIL、INR水平及MELD评分差异无统计学意：义（P>0・05）:抗病毒治疗纽异有统计学意低于对照组，论转，抑肝衰竭期预后。关键词：中图分义（PV0.05）。治疗3个月差异有统计学宜义（PV0・05）。制病希复制，具有肯定的患者的长HBVDNA水平显著低于对及1年后抗病毒治疗组ALT、AST.TBIL.INR.HBVDNA水平及MELD评结抗病毒治疗可降低慢性乙型肝炎肝衰竭患者好治疗作用。病悄好转后维持抗病希治疗，可以慢性乙型重型肝炎：抗病毒治疗；IIBVDNA；预后类号：R5I2.62文献标识码：B文章编号：1672-3619（2013）11-1351-04的死匸率，加快东江门例病毒药牡、HBV后，抗后抗病者ALT、组，差分显著肝功能ResultsAfterImonthAfter3monthsandoneyearOneyearefficacyofantiviraltherapywithnucleosideanaloguesonchronicseverehepatitisBHEGang!,ZHENPei-lin2,DINGPei-peiuCHENXiao-huai,LIANGShao-qunuZHENYue-yim(1・DepartmentofInfectiousDisease,JiangmenMunicipalCentralHospital,Guangdong,Jiangmen529030；2・ScienceandEducationDivision,JiangmenMunicipalCentralHospital»Guangdong,Jiangmen529030,China)Abstract：ObjectiveToinvestigatetheoneyearefficacyofantiviraltreatmentinpatientswithchronicseverehepatitisB・MethodsPatientswithchronicseverehepatitisBwerecollected・Antiviraltreatmentgroup(54cases)wastreatedwithantiviraltherapy(LAMorETVrorLtd)androutinesupportivetherapy»andthecontrolgroup(67historicaleases)wastreatedwithsupportivetherapyonly.Themortality,hepatitisBvirusDNA(HBVDNA)levelrTNR(intemationalnormalizedratio)MELDscoreandliverfunctionbetweenthetwogroupsindifferentlimepointswerecompared.treatment,Therewasnosignificantdifferenceinthemortalitybetween(he2groups(P>0.05)・ButAfter3monthstreatrnent.15patientsdied(27・8%)inantiviraltreatmentgroup,whichwassignificantlylowerthanthatinthecontrolgroup[32patientsdied(47.8%),P<0.05]・After1yeartreatment,15patientsdied(27.X%)inantiviraltreatmentgroup,whichwassignificantlylowerthanthatincontrolgroup[37patientsdied(61・7%),PV0・05]•Afterimonthtreatment»TherewasnosignificantlydifferenceintheALT,AST,TBILtINRandMELDscorebetweenthe2groups(P>0.05),butthelevelofHBVrDNAinantiviraltreatmentgroupwassignificantlylowerthanthatofcontrolgroup(PV0・05)・treatment»theALT,AST,TBIL»INRandMELDscoreandthelevelofHB\rDNAinantiviraltreatmentgroupwereallsignificantlylowerthanthoseincontrolgroup(P<0・05)・ConclusionAntiviraltreatmentcandecreasemortality»improveliverfxinction,inhibitviralreplication♦withapositivetherapeuticeffect・Antiviraltreatmentshouldbemaintainedafterpatients基金项目:江门市科技局科研课题（江科[2012]107号）作者简介:何纲（1978—儿男，硕士，副主任医师，主要从事病和内毒素血症三重致死性打击。性及HBV的高度复制炎临床研究淋巴细胞为主要效应的细胞免疫反应，同时产生大arcbetter,foritcanimprovelongtermprognosis・Ke...