摘要
目的探讨短疗程糖皮质激素治疗药物性亚急性肝衰竭早期患者的临床疗效及其安全性。方法回顾性分析2003年3月至2010年12月收治的83例早期药物性亚急性肝衰竭患者的临床资料。患者分为两组。对照组47例,给予常规内科综合治疗;治疗组36例,在常规内科综合治疗基础上加用糖皮质激素(地塞米松10mg,1次/d静脉注射)治疗1周。观察两组的临床疗效与不良反应。结果治疗组症状好转率明显高于对照组(77.8%vs.40.4%,P<0.01)。两组治疗前总胆红素(TBIL)、白蛋白(ALB)、凝血酶原活动度(PTA)无明显差异;治疗1周后,治疗组较对照组明显改善(203.8±89.5vs.260.3±105.8,P<0.01;34.4±1.8vs.33.5±2.1,P<0.05;37.5±3.2vs.35.8±3.5,P<0.05);治疗组救治成功率(58.3%)也明显高于对照组(34.0%),差异有统计学意义(P<0.05)。两组间各种并发症发生率的差异无统计学意义(P>0.05)。结论短疗程糖皮质激素可以提高早期药物性亚急性肝衰竭患者救治的成功率。如严格把握糖皮质激素应用指征及治疗时机,其临床应用是较为安全的。
Objective To observe the clinical efficacy and safety of shorter-term glucocorticoid to drug-induced liver failure. Methods Eighty-three patients of early drug-induced liver failure were divided into two groups （control and treatment）, and studied by retrospective analysis. Control group （47 patients） was received with practice of integrated treatment, and treatment group （36 patients） was received with practice of integrated treatment and glucocorticoid for 1 week （dexamethasone 10 mg/d I.V.）. After treatment, the success rate and adverse reaction were compared between the two groups. Result The effective rate of treatment was significantly higher than control group（77.8% vs. 40.4%, P 0.01）. TBIL, ALB and PTA of treatment group were improved obviously than control group respectively （203.8±89.5 vs. 260.3±105.8, P 0.01; 34.4±1.8 vs. 33.5±2.1, P 0.05; 37.5±3.2 vs. 35.8±3.5, P 0.05）. The success rate of treatment was significantly higher than control group（58.3 % vs. 34.0 %,P 0.01）. There was no significant difference between two groups for the incidence of complications. Conclusion The treatment of shorter-term glucocorticoid can improve the success rate in early drug-induced liver failure. These results suggest that when we really understand the application indications and treatment opportunity, clinical application of glucocorticoid is relatively safe.
出处
《北京医学》
CAS
2012年第3期174-176,共3页
Beijing Medical Journal
关键词
糖皮质激素
肝功能衰竭
药物性肝炎
治疗
Glucocoriticoid Liver failure Drug-induced hepatitis Treatment
