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[乙型肝炎的治疗]

[Treatment of hepatitis B].

作者信息

Telegdy László

机构信息

Fovárosi Onkormányzat, Szent László Kórháza, Hepatológiai Ambulancia, Budapest.

出版信息

Orv Hetil. 2004 Nov 7;145(45):2293-6.

Abstract

Treatment of hepatitis B. Treatment of acute icteric hepatitis B is similar to the principles of treatment of acute hepatitis syndrome. Special care must be given to the possibility of fulminant outcome and to the trend to chronicity. Diagnosis and treatment of chronic hepatitis B serves prevention of liver cirrhosis and hepatocellular carcinoma as well as elimination of the sources of further infections. Interferon-alpha treatment results in sustained clinical and virological response in about half of the patients. Nucleoside analogues as lamivudine, entecavir, adenovir dipivoxil are the alternatives. They are effective also in endstage liver cirrhosis caused by hepatitis B virus and able to prevent reinfection and graft loss after liver transplantation. Evaluation of the benefits and disadvantages of the antiviral agents help to determine the individual, patient-tailored treatment.

摘要

乙型肝炎的治疗。急性黄疸型乙型肝炎的治疗与急性肝炎综合征的治疗原则相似。必须特别关注暴发性结局的可能性以及慢性化趋势。慢性乙型肝炎的诊断和治疗有助于预防肝硬化和肝细胞癌,并消除进一步感染的源头。α干扰素治疗可使约一半的患者获得持续的临床和病毒学应答。核苷类似物如拉米夫定、恩替卡韦、阿德福韦酯是替代药物。它们对乙型肝炎病毒引起的终末期肝硬化也有效,并且能够预防肝移植后的再感染和移植物丢失。评估抗病毒药物的利弊有助于确定个体化的、针对患者的治疗方案。

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