严重病毒性肝病的病因治疗新认识.pdfVIP

1637 王字明.严重病毒性肝病的病因治疗新认识 述评 严重病毒性肝病的病因治疗新认识 王宇明 (第三军医大学附属西南医院全军感染病研究所，重庆4∞038) 摘要:严重病毒性肝病的病因非常复杂，不同地区之间存在很大差异，在我国以乙型肝炎和丙型肝炎最为常见。已证明抗病毒 治疗在 HBV 相关严重肝病中具有重要意义，需长期乃至终生用药i 选用药物仍需注意强效、低耐药和安全性;肾功能不全者应慎用 核昔酸类药物;但对于即将接受或已使用免疫抑制剂的 HBV 感染患者，预防性或早期抗病毒治疗至关重要。现研究支持HCV 相关 严重肝病包括伴有慢性肾脏疾病的患者使用直接抗病毒药物治疗方案，初步获得满意疗效，但复发率高于普通患者，故仍需更多、 更大规模、更长时间的临床研究验证。总之，应结合具体情况，采取有效的抗病毒治疗措施，争取提高严重病毒性肝病患者的存 活率。 关键词:肝疾病;治疗;述评 中固分类号:盯75 文献标志码:A 文章编号:1 ∞1 -5256(2016)09 -1637 -07 A new understanding of etiological treatment in patients with severe vi时 hepatitis WANG Yumi昭. (lnstit脚for lnfectωω Diseases ， Soωhwest Hospi，ω1 of Third Military Medical University , Chon明ing 400038 , China) Abstract: Severe viral hepatitis has a various etiology , which varies greatly among different regions. Hepatitis B and hepatitis C are com- monly seen in China. It has been proved that antiviral therapy has great significance in HBV - related severe liver disease , and they often need long - term or lifetime medication. 币le selection of drugs should consider potency , low resistance , and safety. Patients with renal in- sufficiency should use nucleoside analogues with a note of caution. As for patients with HBV infection who plan to use or have already used immunosuppressants , antiviral therapy is of vital importance. Current studies suppo此 the therapeutic regimen with direct - acting antiviral a- gents in patients with severe hepatitis complicated by chronic renal disease. This therapy has achieved a satisfactory effect , but such patients tend to have a higher recuπence rate than general patients. 叽lerefore ， more large - scale clinical studies which last for a longer time are nee-