Pentoxifylline versus prednisolone for severe alcoholic hepatitis: A randomized controlled trial
Pentoxifylline versus prednisolone for severe alcoholic hepatitis: A randomized controlled trial
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DOI：
10.3748/wjg.15.1613
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发表时间：
2009-04-07
影响因子：
4.3
通讯作者：
Ghosh, Pramit
中科院分区：
文献类型：
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作者：
De, Binay Krishna;Gangopadhyay, Subhabrata;Ghosh, Pramit
目的：比较喷替福林与泼尼松龙治疗重型酒精性肝炎的疗效，评价不同肝功能评分对预后的预测作用。重型酒精性肝炎68例（精神病评分>= 32）接受戊巴比妥钠（n = 34，组I）或泼尼松龙（n = 34，E组）在随机双盲对照研究中28 d，随后在开放研究中结果：H组3个月时死亡12例，I组5例。第11组在3个月结束时的死亡概率高于第1组（35.29% vs 14.71%，P = 0.04;对数秩检验）。R组6例患者发生肝肾综合征，而I组无患者发生肝肾综合征。在治疗28天结束时，喷替福林与终末期肝病模型（MELD）评分显著降低相关（15.53 +/- 3.63 vs 17.78 +/- 4.56，P = 0.04）。较高的基线Madelyn评分与增加mortals.CONCLUSION：降低死亡率，改善风险-效益和肾保护作用的pendulfylline相比，泼尼松龙表明，pendulfylline是优于泼尼松龙治疗重型酒精性肝炎上级。(C)2009 WJG出版社和百世登。All rights reserved.
AIM: To compare the efficacy of pentoxifylline and prednisolone in the treatment of severe alcoholic hepatitis, and to evaluate the role of different liver function scores in predicting prognosis.METHODS: Sixty-eight patients with severe alcoholic hepatitis (Maddrey score >= 32) received pentoxifylline (n = 34, group I) or prednisolone (n = 34, group E) for 28 d in a randomized double-blind controlled study, and subsequently in an open study (with a tapering dose of prednisolone) for a total of 3 mo, and were followed up over a period of 12 mo.RESULTS: Twelve patients in group H died at the end of 3 mo in contrast to five patients in group I. The probability of dying at the end of 3 mo was higher in group 11 as compared to group 1 (35.29% vs 14.71%, P = 0.04; log rank test). Six patients in group R developed hepatorenal syndrome as compared to none in group I. Pentoxifylline was associated with a significantly lower model for end-stage liver disease (MELD) score at the end of 28 d of therapy (15.53 +/- 3.63 vs 17.78 +/- 4.56, P = 0.04). Higher baseline Maddrey score was associated with increased mortality.CONCLUSION: Reduced mortality improved risk-benefit profile and renoprotective effects of pentoxifylline compared with prednisolone suggest that pentoxifylline is superior to prednisolone for treatment of severe alcoholic hepatitis. (C) 2009 The WJG Press and Baishideng. All rights reserved.