中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Menu
Issue 7
Jul.  2016
Turn off MathJax
Article Contents
Abstract
References
Article Navigation >  Journal of Clinical Hepatology  > 2016  >  32(7): 1300-1304

Efficacy of low-dose glucocorticoids in treatment of HBV-related acute-on-chronic liver failure

DOI: 10.3969/j.issn.1001-5256.2016.07.017
Research funding:

 

  • Published Date: 2016-07-20
    Abstract
  • Objective To investigate the efficacy and safety of low- dose glucocorticoids in the treatment of HBV- related acute- on-chronic liver failure( HBV- ACLF). Methods A total of 118 patients with HBV- ACLF who were treated in Center for Liver Disease Treatment in the Fourth People's Hospital of Panzhihua from January 2012 to October 2015 were enrolled and randomly divided into treatment group and control group,with 59 patients in each group. All the patients were given antiviral therapy with entecavir and conventional liver-protecting and symptomatic treatment,and the patients in the treatment group were given intravenous drip of low- dose hydrocortisone sodium succinate( 25 mg / d) in addition. The clinical manifestations,biochemical parameters for liver function,adverse events,length of hospital stay,and hospital costs were recorded for all patients. The t- test was used for comparison of continuous data between groups,the paired t- test was used for comparison of continuous data within groups,and the chi- square test or Fisher's exact test was used for comparison of categorical data between groups. Results At the end of the course of the treatment,the treatment group showed significantly better improvements in the biochemical parameters for liver function( alanine aminotransferase,aspartate aminotransferase,total bilirubin,albumin,cholinesterase,and prothrombin activity) compared with the control group( all P < 0. 001). The treatment group had a significantly shorter length of hospital stay and significantly lower hospital costs than the control group( length of hospital stay: 48. 0 ± 9. 2 d vs 74. 0 ± 16. 4 d,t = 4. 34,P < 0. 01; hospital costs: 7974. 5 ± 853. 7 RMB / person vs 12 432. 7 ± 1263. 1 RMB / person,t = 22. 46,P < 0. 01). No patients in the treatment group experienced adverse events related to hydrocortisone sodium succinate. Conclusion In the treatment of HBV- ACLF,low- dose hydrocortisone sodium succinate can eliminate jaundice,alleviate conditions,and improve the prognosis. Meanwhile,it can also shorten the length of hospital stay and reduce hospital costs. This drug has good safety and holds promise for further clinical research.

     

    • FullText(HTML)
    • References(20)
  • [1]ZHANG YL,HAN T,ZHANG M,et al.Research progress in prognostic markers of acute-on-chronic liver failure[J].J Clin Hepatol,2014,30(10):1078-1081.(in Chinese)张玉玲,韩涛,张敏,等.慢加急性肝衰竭预后标志物的研究进展[J].临床肝胆病杂志,2014,30(10):1078-1081.
    [2] Liver Failure and Artificial Liver Group,Chinese Society of Infectious Diseases,CMA;Severe Liver Diseases and Artificial Liver Group,Chinese Society of Hepatology,CMA.Guideline for diagnosis and treatment of liver failure(2012 version)[J].Chin J Clin Infect Dis,2012,5(6):321-327.(in Chinese)中华医学会感染病学分会肝衰竭与人工肝治疗组,中华医学会肝病学分会重型肝病与人工肝学组.肝衰竭诊治指南(2012年版)[J].中华临床感染病杂志,2012,5(6):321-327.
    [3]LIU H,CHEN G,GAN XM.Research advances in new approaches to treatment of acute-on-chronic liver failure[J].J Clin Hepatol,2015,31(9):1496-1500.(in Chinese)刘洪,陈刚,甘雪梅.慢加急性肝衰竭治疗的新技术及其研究进展[J].临床肝胆病杂志,2015,31(9):1496-1500.
    [4]ZHANG XQ,NIE QH.Application and effect of glucocorticoids in treatment of severe hepatitis[J].J Pract Hepatol,2004,7(2):70-72.(in Chinese)张绪清,聂青和.糖皮质激素在治疗重型肝炎中的应用及评价[J].实用肝脏病杂志,2004,7(2):70-72.
    [5]LI LJ,REN H.Infectious Diseases[M].8th ed.Beijing:People's Medical Publishing House,2013:29-30.(in Chinese)李兰娟,任红.传染病学[M].8版.北京:人民卫生出版社,2013:29-30.
    [6]Chinese Society of Hepatology and Chinese Society of Infectious Diseases,Chinese Medical Association.The guideline of prevention and treatment for chronic hepatitis B:a 2015 update[J].J Clin Hepatol,2015,31(12):1941-1960.(in Chinese)中华医学会肝病学分会,中华医学会感染病学分会.慢性乙型肝炎防治指南(2015年更新版)[J].临床肝胆病杂志,2015,31(12):1941-1960.
    [7]WANG TM,QIU B,LI SM,et al.Clinical efficacy of lamivudine and thymosinα1 combined with artificial extracorporeal liver support therapy in treatment of severe hepatitis B[J].Chin Hepatol,2008,13(2):145-147.(in Chinese)王堂明,邱波,李树民,等.拉米夫定、胸腺肽α1联合人工肝治疗重型乙型肝炎的临床研究[J].肝脏,2008,13(2):145-147.
    [8]XIA SL,HE XF.Efficacy of entecavir treatment for patients with chronic hepatitis B[J].J Clin Hepatol,2015,31(4):523-525.(in Chinese)夏淑林,何小峰.恩替卡韦治疗慢性乙型肝炎的疗效观察[J].临床肝胆病杂志,2015,31(4):523-525.
    [9]DENG ZP.Efficacy and safety of entecavir on hepatitis B[J].Chin J New Drugs Clin Remed,2005,24(4):326-329.(in Chinese)邓中平.恩替卡韦治疗乙型肝炎的疗效及安全性[J].中国新药与临床杂志,2005,24(4):326-329.
    [10] COURSIN DB,WOOD KE.Corticosteroid supplementation for adrenal insufficiency[J].JAMA,2002,287(2):236-240.
    [11]JIANG XH,GU XB.Change in serum cortisol concentration in patients with severe chronic hepatitis and its clinical significance[J].Jiangsu Med J,2004,30(6):464.(in Chinese)蒋祥虎,顾锡炳.慢性重型肝炎血清皮质醇浓度的变化及临床意义[J].江苏医药杂志,2004,30(6):464.
    [12]ZHANG L,HAN F,WU D,et al.Relationship between sera hydrocortisone level and the prognosis of fulminant hepatitis[J].JClin Hepatol,2011,27(5):538-539.(in Chinese)张琳,韩峰,吴丹,等.血清皮质醇水平与重型肝炎预后的相关性[J].临床肝胆病杂志,2011,27(5):538-539.
    [13]WANG HH.Low-dose corticosteroid therapy for tendency to subacute severe hepatitis:an analysis of 46 cases[J].Pract Clin Med,2001,2(4):22,24.(in Chinese)王汉华.小剂量激素治疗亚急性重症肝炎倾向46例[J].实用临床医学,2001,2(4):22,24.
    [14]SUN S.Low-dose corticosteroid therapy for acute hepatitis E-associated hyperbilirubinemia:an analysis of 17 cases[J].Chin J Integr Tradit West Med Liver Dis,2002,12(5):299.(in Chinese)孙苏.小剂量激素治疗急性戊型肝炎高胆红素血症17例[J].中西医结合肝病杂志,2002,12(5):299.
    [15]LEI NF,LIU TH,HE ZY.Analysis of blocking effect and safety of glucocorticoid de-escalation combined with antiviral therapy in the treatment of early severe hepatitis B[J].China Prac Med,2015,10(30):5-7.(in Chinese)雷南凤,刘添皇,何宗运.糖皮质激素降阶梯联合抗病毒治疗对早期乙型重症肝炎的阻断效果及安全性分析[J].中国实用医药,2015,10(30):5-7.
    [16]CHEN CX,LIU B,GUO SM,et al.Glycocorticosteroid administration prevents occurrence of necrotic hepatitis in patients with chronic hepatitis B of severe degree[J].J Trop Dis Parasitol,2004,2(2):68-74,105.(in Chinese)陈从新,刘波,郭顺明,等.应用糖皮质激素治疗慢性乙型肝炎重度患者阻断坏死性肝炎的发生[J].热带病与寄生虫学,2004,2(2):68-74,105.
    [17]ZHOU XS,WAN MB,XUE JY,et al.Effects of glucocorticoids combined with antiviral therapy in treatment of patients with chronic severe hepatitis B[J].J Clin Hepatol,2008,24(2):101-103.(in Chinese)周先珊,万谟彬,薛建亚,等.抗病毒基础上应用糖皮质激素治疗慢性重型乙型肝炎临床分析[J].临床肝胆病杂志,2008,24(2):101-103.
    [18]WU JY,LI M,ZHANG H.Effect of glucocorticoid treatment on the clinical ontcome of patients with early-stage liver failure[J].JSouth Med Univ,2011,31(3):554-556.(in Chinese)吴锦瑜,黎明,张华.糖皮质激素治疗对早期肝衰竭患者转归的影响[J].南方医科大学学报,2011,31(3):554-556.
    [19]YANG XK,XU GS.Efficacy of glucocorticoid in treatment of HBV-related hepatic failure:a meta-analysis[J].Med J Chin PLA,2013,38(7):581-584.(in Chinese)杨晓鲲,徐贵森.糖皮质激素治疗乙型肝炎病毒相关性肝衰竭疗效的Meta分析[J].解放军医学杂志,2013,38(7):581-584.
    [20]SONG P,LIU W,LIU TJ,et al.Efficacy and safety of glucocorticoids in treatment of severe chronic hepatitis B:a meta-analysis[J].Chongqing Med,2015,44(24):3407-3410.(in Chinese)宋攀,刘伟,刘天杰,等.糖皮质激素对慢性重度乙型肝炎疗效及安全性的Meta分析[J].重庆医学,2015,44(24):3407-3410.
    • Relative Articles

  • Relative Articles

    [1]Wei YAN, Huifang HUANG. Effect of glucocorticoid in the treatment of severe drug-induced liver injury[J]. Journal of Clinical Hepatology, 2022, 38(10): 2302-2307. doi: 10.3969/j.issn.1001-5256.2022.10.019
    [2]Long LIU, Yao LIU, Fangyuan GAO, Xianbo WANG. Clinical features of chronic liver disease with autoimmune blood diseases and the clinical effect of glucocorticoid[J]. Journal of Clinical Hepatology, 2021, 37(8): 1878-1882. doi: 10.3969/j.issn.1001-5256.2021.08.025
    [3]Dong JinLing, Jia Lin, Yang Jun, Yu HongWei, Hu ZhongJie, Zhu YueKe, Meng QingHua. Expression features of glucocorticoid receptor and its association with treatment outcome in patients with hepatitis B virus-related acute-on-chronic liver failure[J]. Journal of Clinical Hepatology, 2020, 36(6): 1252-1257. doi: 10.3969/j.issn.1001-5256.2020.06.013
    [4]Yang Jun, Hu ZhongJie, Zhu YueKe, Yu HongWei, Li Juan, Hou Wei, Ning QiQi. Clinical effect of glucocorticoids versus pentoxifylline in patients with severe alcoholic liver disease: A Meta-analysis[J]. Journal of Clinical Hepatology, 2019, 35(7): 1546-1550. doi: 10.3969/j.issn.1001-5256.2019.07.025
    [5]Zhao YouYou, Zhang Duan, Yin Xin, Wen XiaoYu, Gao PuJun. Glucocorticoid treatment of intrahepatic cholestasis caused by infectious cholangitis: A case report[J]. Journal of Clinical Hepatology, 2019, 35(2): 386-387. doi: 10.3969/j.issn.1001-5256.2019.02.031
    [6]Ma Juan, Liu YuLan. Corticosteroid therapy for autoimmune pancreatitis[J]. Journal of Clinical Hepatology, 2018, 34(8): 1599-1603. doi: 10.3969/j.issn.1001-5256.2018.08.002
    [7]Wang XiuFang, Feng GuoHe. Research advances in glucocorticoids for the treatment of liver failure[J]. Journal of Clinical Hepatology, 2018, 34(7): 1565-1568. doi: 10.3969/j.issn.1001-5256.2018.07.043
    [8]Yang FangJi, Peng Liang, Gao ZhiLiang. New strategies for diagnosis and treatment of hepatitis B virus-related liver failure[J]. Journal of Clinical Hepatology, 2017, 33(3): 582-587. doi: 10.3969/j.issn.1001-5256.2017.03.041
    [9]Meng QingHua. Timing of glucocorticoid therapy for liver failure[J]. Journal of Clinical Hepatology, 2017, 33(9): 1683-1686. doi: 10.3969/j.issn.1001-5256.2017.09.011
    [10]Ma Zhen, Wu Yun. Current status of liver failure treatment[J]. Journal of Clinical Hepatology, 2016, 32(9): 1668-1672. doi: 10.3969/j.issn.1001-5256.2016.09.007
    [11]Liu LiBin, Wang Min, Tian YueLi, Cong Jing, Wang LiYing. Severe fatty liver induced by glucocorticoids: a report of one case[J]. Journal of Clinical Hepatology, 2016, 32(1): 161-162. doi: 10.3969/j.issn.1001-5256.2016.01.034
    [12]Chang BinXia, Teng GuangJu, Sun Ying, Zhao Jun, Zhang Wei, Zou ZhengSheng, Li BaoSen. Drug-induced liver injury caused by treatment of complications after glucocorticoid therapy for panniculitis: a report of one case[J]. Journal of Clinical Hepatology, 2015, 31(5): 775-776. doi: 10.3969/j.issn.1001-5256.2015.05.035
    [13]Ge HongYan, Wang YingShu. Clinical efficacy of glucocorticoid therapy in treatment of drug-induced cholestatic liver disease[J]. Journal of Clinical Hepatology, 2015, 31(10): 1618-1620. doi: 10.3969/j.issn.1001-5256.2015.10.014
    [14]Wang Xian, Wang ShaoYang, Huang DeDong, Chen Jian, Chen DeLiang. Analysis of short-term prognostic factors in patients with HBV-related acute-on-chronic liver failure treated with artificial liver support system[J]. Journal of Clinical Hepatology, 2014, 30(4): 367-369. doi: 10.3969/j.issn.1001-5256.2014.04.020
    [15]You ShaoLi, Liu HongLing, Rong YiHui, Zhu Bing, Zang Hong, Liu WanShu, Wan ZhiHong, Mao PanYong, Xin ShaoJie. Preliminary investigation of hybrid bioartificial liver support system in treatment of HBV- related acute- on- chronic liver failure[J]. Journal of Clinical Hepatology, 2013, 29(9): 685-688. doi: 10.3969/j.issn.1001-5256.2013.09.013
    [16]Zhang WenHua, Jia WenLing, Zhou ZiYing, Tang HaiTao, Wang FengMei. Investigation on the method and safety of the non-heparinized plasma exchange therapy in treating patients with hepatic failure[J]. Journal of Clinical Hepatology, 2012, 28(1): 50-52.
    [17]Zhou XinMin, Dong XuYang. Therapeutic strategies of liver failure for clinical cases[J]. Journal of Clinical Hepatology, 2012, 28(2): 93-98.
    [18]Wang Meng, Nie QingHe. Meta-analysis of the efficacy and complications of glucocorticoids in patients with severe hepatitis-related liver failure [J]. Journal of Clinical Hepatology, 2012, 28(10): 764-770.
    [19]Li ShuangXing, Shi LiJun, Wang XiuJie. Effects of bone marrow mesenchymal stem cells transplantation into rats with acute liver failure[J]. Journal of Clinical Hepatology, 2010, 26(6): 624-626.
    [20]Liang Jing, Kan ZhiChao, Zhang JianDong. The clinical characteristics and treatment of liver failure patients with spontaneous bacterial peritonitis[J]. Journal of Clinical Hepatology, 2010, 26(6): 621-623.
    • Supplements(0)
    • Cited By

  • Cited by

    Periodical cited type(15)

    1. 夏魏. 小剂量糖皮质激素联合肝部分切除术对肝内胆管结石患者术后残余及肝功能的影响. 微量元素与健康研究. 2020(03): 30-31+35 .
    2. 高朋彬，郑欢伟，赵晓彦，王德华，秦浩，孟明辉，张建集，闫双缓. 内科综合治疗HBV-ACLF患者的临床特点及转归. 肝脏. 2020(04): 375-378 .
    3. 高安，孙蔚，甘建和. 糖皮质激素治疗HBV相关性肝衰竭疗效及安全性Meta分析. 江苏医药. 2020(12): 1242-1248 .
    4. 余春启. 甲泼尼龙与恩替卡韦联用对乙型肝炎患者急慢性肝衰竭的临床疗效评价. 抗感染药学. 2019(02): 345-347 .
    5. 苏宏正. HBV-ACLF病情转归与血清内源性糖皮质激素水平的关系. 西南国防医药. 2019(04): 446-448 .
    6. 苏日嘎. 探讨小剂量糖皮质激素治疗HBV相关慢加急性肝衰竭的临床疗效. 智慧健康. 2019(14): 152-153 .
    7. 储君，杨燕卿，林世德. 糖皮质激素治疗乙型肝炎病毒相关慢加急性肝衰竭的研究进展. 海南医学. 2019(17): 2274-2276 .
    8. 李娜，顾欢，朱英，赵钢. 肝衰竭治疗的最新进展. 医学与哲学(B). 2018(08): 50-54 .
    9. 罗森，孟忠吉，龚作炯. 糖皮质激素治疗乙肝病毒相关慢加急性肝衰竭前期及早期的疗效观察. 中西医结合肝病杂志. 2018(02): 79-81+87 .
    10. 李正，任杨华，朱同玉，艾晓杰，史懿. 糖皮质激素对急性肺损伤小鼠肺功能影响研究. 临床军医杂志. 2018(12): 1402-1404+1407 .
    11. 康桂红. 恩替卡韦治疗hbv相关慢加急性肝衰竭效果及安全性. 疾病监测与控制. 2017(06): 486-488 .
    12. 赵金城. 小剂量糖皮质激素治疗HBV相关慢加急性肝衰竭的效果探讨. 系统医学. 2017(07): 61-64 .
    13. 梁政，刘海燕，邱芳英. 小剂量糖皮质激素治疗HBV相关慢加急性肝衰竭的效果分析. 中国实用医药. 2017(33): 89-90 .
    14. 刘晓燕，陈婧，肖珑，童晶晶，关崇丹，严立龙，苏海滨. 停用核苷和核苷酸类药物诱发HBV相关慢加急性肝衰竭患者的临床特点分析. 临床肝胆病杂志. 2016(09): 1766-1769 . 本站查看
    15. 陈姼姼，陈晓蓉，陆云飞. 急性重型乙型肝炎合并HIV感染1例报告. 临床肝胆病杂志. 2016(09): 1787-1788 . 本站查看

    Other cited types(3)

  • 加载中
    Created with Highcharts 5.0.7Chart context menuAccess Class DistributionFULLTEXT: 10.3 %FULLTEXT: 10.3 %META: 86.2 %META: 86.2 %PDF: 3.4 %PDF: 3.4 %FULLTEXTMETAPDF
    Created with Highcharts 5.0.7Chart context menuAccess Area Distribution其他: 6.2 %其他: 6.2 %其他: 2.3 %其他: 2.3 %India: 0.2 %India: 0.2 %上海: 7.6 %上海: 7.6 %亳州: 0.5 %亳州: 0.5 %北京: 17.2 %北京: 17.2 %匹兹堡: 0.2 %匹兹堡: 0.2 %南宁: 0.2 %南宁: 0.2 %南通: 0.2 %南通: 0.2 %厦门: 0.2 %厦门: 0.2 %台州: 0.2 %台州: 0.2 %吉林: 0.9 %吉林: 0.9 %哥伦布: 0.5 %哥伦布: 0.5 %大连: 0.2 %大连: 0.2 %天津: 0.2 %天津: 0.2 %宁波: 0.5 %宁波: 0.5 %宜宾: 0.9 %宜宾: 0.9 %密蘇里城: 0.2 %密蘇里城: 0.2 %张家口: 2.5 %张家口: 2.5 %昆明: 0.2 %昆明: 0.2 %梧州: 0.9 %梧州: 0.9 %泉州: 0.2 %泉州: 0.2 %洛阳: 0.2 %洛阳: 0.2 %淄博: 0.7 %淄博: 0.7 %深圳: 0.5 %深圳: 0.5 %盐城: 0.2 %盐城: 0.2 %芒廷维尤: 34.6 %芒廷维尤: 34.6 %芝加哥: 0.5 %芝加哥: 0.5 %莫斯科: 1.8 %莫斯科: 1.8 %西宁: 16.7 %西宁: 16.7 %重庆: 0.7 %重庆: 0.7 %铁岭: 0.5 %铁岭: 0.5 %长春: 0.5 %长春: 0.5 %长沙: 0.2 %长沙: 0.2 %长治: 0.2 %长治: 0.2 %青岛: 0.2 %青岛: 0.2 %其他其他India上海亳州北京匹兹堡南宁南通厦门台州吉林哥伦布大连天津宁波宜宾密蘇里城张家口昆明梧州泉州洛阳淄博深圳盐城芒廷维尤芝加哥莫斯科西宁重庆铁岭长春长沙长治青岛

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索
    Get Citation
    PDF
    XML

    Article Metrics

    Article views (2300) PDF downloads(492) Cited by(18)
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[2008]YesterdayPV[3584]TodayIP[1340]TodayPV[2481]Online[99]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return