目的:观察丁二磺酸腺苷蛋氨酸辅助治疗慢性乙型肝炎重叠急性戊型肝炎的临床疗效及安全性.方法:将30例慢性乙型肝炎重叠急性戊型肝炎患者随机分为两组.A组(16例)患者给予丁二磺酸腺苷蛋氨酸1 000 mg加入10％葡萄糖注射液250ml中静脉滴注,qd,同时口服恩替卡韦抗病毒并进行综合护肝治疗(还原型谷胱甘肽等)；B组(14例)患者口服恩替卡韦抗病毒并进行综合护肝治疗(还原型谷胱甘肽等).两组疗程均为3周.观察两组患者血清总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、碱性磷酸酶(ALP)、谷氨酰转移酶(GGT)、白蛋白(ALB)及凝血酶原活动度(PTA)的变化情况,并观察不良反应情况.结果:治疗后A组患者的TBIL、ALT、ALP及GGT水平均显著低于B组(P＜0.05),ALB及PTA水平均显著高于B组(P＜0.05).A组患者治疗总有效率为93.75％,而B组为64.29％,A组显著高于B组(P＜0.05).两组患者临床症状均有不同程度好转,且均未见明显不良反应发生.结论:丁二磺酸腺苷蛋氨酸辅助治疗慢性乙型肝炎重叠急性戊型肝炎疗效较好,能促进患者黄疸消退、改善肝功能,且安全性较好.%OBJECTIVE:To observe the clinical efficacy and safety of succinic acid adenosine methionine in the treatment of chronic hepatitis B overlapping acute hepatitis E.METHODS:30 patients with chronic hepatitis B overlapping acute hepatitis E in our hospital were randomly divided into 2 groups,i.e.16 cases in group A were given succinic acid adenosine methionine 1 000 mg added into 10％ Glucose injection 250 ml,i.v.qd and Entecavir combined with the basic protect liver therapy (reduced glutathione) orally; 14 cases in treatment group B were given Entecavir combined with the basic protect liver therapy (reduced glutathione).The duration of treatment was 3 weeks; the changes of TBIL,ALT,ALP,GGT,ALB and PTA were observed in 2 groups,and adverse drug reactions were also observed.RESULTS:After treatment,the TBIL,ALT,ALP and GGT of group A were lower than those of group B (P＜0.05),while PTA and ALB were higher in group B (P＜0.05) ; the total effective rate of group A was 93.75％,and that of group B was 64.29％,that of group A was significantly higher than that of group B (P＜0.05) ; clinical symptoms of 2 groups were improved to different extent,and there was no severe adverse effects in 2 groups.CONCLUSIONS:Succinic acid adenosine methionine have synergy in promoting jaundice subsidise,improving liver function in the treatment of patients with chronic hepatitis B overlapping acute hepatitis E,and the safety is also better.
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