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目的观察核苷(酸)类似物治疗慢加急性肝衰竭的临床效果。方法回顾性分析2008年6月-2009年6月间在我院治疗的65例HBV—ACLF患者的临床资料,深入研究并分析核苷(酸)类似物治疗慢加急性肝衰竭的治疗过程。结果服用恩替卡韦或拉米夫定的2组患者乳酸升高比率的差异无统计学意义。临床无确切引起乳酸升高原因的5例患者,乳酸呈一过性升高,且预后良好。结论 HBV-ACLF患者抗病毒治疗过程中乳酸升高主要原因是感染和肝肾综合征。核苷类似物治疗HBV—ACLF未引发显著的乳酸升高,适合大力推广。
Objective To observe the clinical effect of nucleoside (acid) analogues in treating acute and acute liver failure. Methods The clinical data of 65 patients with HBV-ACLF treated in our hospital from June 2008 to June 2009 were analyzed retrospectively. The treatment process of nucleoside (acid) analogue for treatment of patients with acute and chronic liver failure was further studied and analyzed. Results There was no significant difference in the rate of lactate increase between the two groups taking entecavir or lamivudine. In 5 patients with clinically unreasonable causes of elevated lactate, lactic acid was transiently elevated with a good prognosis. Conclusion The main reason of the increase of lactic acid in HBV-ACLF patients during antiviral therapy is infection and hepatorenal syndrome. Nucleoside analogue treatment of HBV-ACLF did not lead to significant increase in lactate, suitable for promotion.