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目的分析酒精性肝病(alcoholic hepatitis,ALD)合并乙型肝炎病毒(hepatitis B virus,HBV)感染的临床特点。方法 50例ALD合并HBV感染患者为ALD合并HBV组,70例单纯ALD患者为单纯ALD组,2组患者入院后均戒酒、并给予营养支持和对症治疗;比较2组治疗前乏力、腹胀、黄疸和消化道出血发生率及肝功能指标,观察治疗8周后肝功能改善情况。结果ALD合并HBV组乏力(64.0%)、腹胀(54.0%)、黄疸(82.0%)及上消化道出血发生率(12.0%)高于单纯ALD组(34.3%、17.1%、31.4%、1.4%)(P<0.05);治疗前ALD合并HBV组谷丙转氨酶[(281.5±70.5)u/L]、谷草转氨酶[(511.7±87.2)u/L]、谷氨酰转肽酶[(549.5±61.5)u/L]、总胆红素水平[(107.8±25.2)μmol/L]均高于单纯ALD组[(190.3±60.5)u/L、(352.4±63.5)u/L、(325.6±56.4)u/L、(80.2±21.1)μmol/L](P<0.05);治疗后,ALD合并HBV组谷丙转氨酶[(92.4±17.9)u/L]、谷草转氨酶[(96.5±17.5)u/L]、谷氨酰转肽酶[(99.5±20.7)u/L]、总胆红素[(70.5±17.4)μmol/L]水平高于单纯ALD组[(55.6±12.2)u/L、(44.7±11.0)u/L、(47.2±13.5)u/L、(40.6±11.9)μmol/L](P<0.05)。结论 ALD合并HBV感染患者病情重,疗效差。
Objective To analyze the clinical features of alcoholic hepatitis (ALD) and hepatitis B virus (HBV) infection. Methods 50 patients with ALD complicated with HBV infection were ALD combined with HBV group and 70 patients with simple ALD were treated with ALD alone. All patients in two groups were given alcohol and were given nutritional support and symptomatic treatment after admission. The fatigue, bloating, Jaundice and gastrointestinal bleeding incidence and liver function indicators to observe the improvement of liver function after 8 weeks of treatment. Results The incidence of abdominal distension (54.0%), jaundice (82.0%) and upper gastrointestinal bleeding in ALD patients with ALD complicated with HBV were significantly higher than those in ALD patients (34.3%, 17.1%, 31.4%, 1.4% ) (P <0.05). Before treatment, the alanine aminotransferase (281.5 ± 70.5) u / L, aspartate aminotransferase (511.7 ± 87.2) u / L and glutamyl transpeptidase (549.5 ± 61.5) u / L, total bilirubin levels (107.8 ± 25.2) μmol / L were significantly higher than those in the ALD group (190.3 ± 60.5u / L, 352.4 ± 63.5u / L, (92.4 ± 17.9) u / L], aspartate aminotransferase [(96.5 ± 17.5) u / L, (80.2 ± 21.1) μmol / L] (99.5 ± 20.7) u / L] and total bilirubin [(70.5 ± 17.4) μmol / L] were higher than those in ALD group [(55.6 ± 12.2) u / L, (44.7 ± 11.0) u / L, (47.2 ± 13.5) u / L, (40.6 ± 11.9) μmol / L] Conclusion Patients with ALD complicated with HBV infection have severe illness and poor curative effect.