目的:运用Meta分析方法评价不同抗病毒策略治疗慢性乙型肝炎经治后低病毒血症(LLV)的临床疗效。方法:检索PubMed、Embase、Web of Science、中国知网(CNKI)、万方知识服务平台(WanFang Data)文献数据库,选取符合纳入标准的治疗慢性乙型肝炎LLV的临床研究文献,使用Rev Man 5.4.1软件进行统计学分析。结果:本研究纳入8篇文献,涉及1 150例患者,经Meta分析后提示与维持原核苷类药物(NAs)治疗相比,换用新NAs的治疗方案可以获得更高的HBV DNA阴转率[RR=5.49,95%CI(3.73,8.08),P<0.01]以及HBeAg清除率[RR=2.77,95%CI(1.33,5.77),P=0.006];含有长效干扰素(PEG-IFN)治疗方法可以获得更高的HBsAg清除率(9/241)[RR=8.29,95%CI(1.01,68.33)],P=0.05];不同治疗策略谷丙转氨酶(ALT)复常率差异无统计学意义(P>0.05)。在含有PEG-IFN治疗策略组中,治疗相关不良事件发生率更高[RR=6.42,95%CI(1.69,24.36),P<0.05]。结论:不同抗病毒策略安全性均较高,换用新NAs治疗可以提高LLV患者HBV DNA阴转率和HBeAg消除率。
目的:观察抗肝衰复方联合人工肝治疗对慢加急性肝衰竭(ACLF)患者血清降钙素原(PCT)、白介素-6 (IL-6)、血清丛生蛋白(Clusterin)、趋化因子受体5 (CCR5)和预后的影响。方法:85例慢加急性肝衰竭患者随机分成两组,其中试验组43例,对照组42例;两组患者均给予人工肝治疗及常规西医治疗,试验组在此基础上加用抗肝衰复方治疗;治疗疗程为4周,并在第12周随访,比较两组治疗前后中医证候评分、肝功能指标、凝血功能指标、炎症因子指标及预后结局。结果:试验组治疗后乏力、腹胀中医证候积分及总积分、MELD评分比对照组同期更低(p p p > 0.05);试验组血清PCT、IL-6、Clusterin、CCR5均较治疗前明显好转,差异具有统计学意义(p p p Objective: Observe the effect of anti-liver failure compound combined with artificial liver on serum procalcitonin (PCT), interleukin-6 (IL-6), serum clusterin, chemokine receptor 5 (CCR5), and prognostic implications in patients with acute-on-chronic liver failure. Methods: 85 patients with acute-on-chronic liver failure were randomly divided into two groups, including 43 cases in the experimental group and 42 cases in the control group. Both groups of patients were given artificial liver treatment and conventional Western medicine treatment, and the experimental group was additionally treated with an anti-liver failure compound;the treatment course was 4 weeks, and follow-up was conducted in the 12th week. The TCM syndrome scores, liver function indicators, coagulation function indicators, inflammatory factor indicators, and prognosis outcomes were compared between the two groups before and after treatment. Results: After treatment, the experimental group’s fatigue, abdominal distension, TCM syndrome scores, total scores, and MELD scores were lower than those of the control group during the same period (p p p > 0.05);the serum PCT, IL-6, Clusterin, and CCR5 in the experimental group were significantly improved compared w
