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目的观察小剂量糖皮质激素治疗早期重症肝炎的临床疗效和预后。方法 2006年～2009年,72例早期重型肝炎患者随机分为两组,对照组36例采用综合治疗,观察组36例采用小剂量糖皮质激素治疗,比较两组主要临床症状、生化指标的变化和临床疗效及预后。结果观察组消化道症状改善时间和黄疸消退时间明显少于对照组(P<0.05)。观察组治疗后TB和PT水平明显低于治疗前水平,差异有统计学意义(P<0.05),并且明显低于同期对照组水平(P<0.05)。而对照组治疗前后TB和PT水平比较,差异无统计学意义(P>0.05)。观察组的治疗有效率明显高于对照组,两组比较差异有统计学意义(P<0.05)。而观察组的病死率明显低于对照组,两组比较差异有统计学意义(P<0.05)。结论应用小剂量糖皮质激素对早期重型肝炎能够明显改善临床症状,提高临床疗效,降低死亡率,是一种有效方法。
Objective To observe the clinical efficacy and prognosis of early treatment of severe hepatitis with low-dose glucocorticoid. Methods From 2006 to 2009, 72 patients with early severe hepatitis were randomly divided into two groups. 36 patients in the control group were treated with combination therapy. 36 patients in the observation group were treated with low-dose glucocorticoid. The main clinical symptoms and biochemical indexes were compared between the two groups And clinical efficacy and prognosis. Results The improvement time of digestive tract symptoms and jaundice in observation group were significantly less than those in control group (P <0.05). The levels of TB and PT in the observation group were significantly lower than those before treatment (P <0.05), and were significantly lower than those in the control group (P <0.05). The control group before and after treatment of TB and PT levels, the difference was not statistically significant (P> 0.05). The observation group treatment efficiency was significantly higher than the control group, the difference between the two groups was statistically significant (P <0.05). The mortality of the observation group was significantly lower than that of the control group, the difference between the two groups was statistically significant (P <0.05). Conclusion The application of low-dose glucocorticoids on early severe hepatitis can significantly improve clinical symptoms, improve clinical efficacy and reduce mortality, is an effective method.