How is anaemia of small three Yang treated?

summary

The so-called "small three yang" refers to the immunological indexes of hepatitis B virus in patients with chronic hepatitis B or HBV carriers, that is, HBsAg, HBeAb and anti HBC are positive. The difference between "big three yang" and "big three yang" is that "big three yang" is e antigen positive and e antibody negative, while "small three yang" is e antigen negative and e antibody negative E antibody was positive. How is anaemia of small three Yang treated? Let's talk about it

How is anaemia of small three Yang treated?

The general indications include: (1) HBV-DNA ≥ 105 copies / ml (equivalent to 20000 IU / ml) in HBeAg positive patients; In HBeAg negative patients, HBV-DNA ≥ 104 copies / ml (equivalent to 2000 IU / ml); ②ALT≧2 × ULN； If treated with IFN, ALT should be ≤ 10 × ULN, serum total bilirubin should be less than 2 × ULN； ③ALT﹤2 × ULN, but liver histology showed Knodell Hai ≥ 4, or inflammatory necrosis ≥ G2, or fibrosis ≥ S2.

The overall goal of chronic hepatitis B treatment is: to maximize the long-term HBV, reduce the inflammatory necrosis and liver fibrosis of hepatocytes, delay and reduce the occurrence of liver decompensation, cirrhosis, HCC and its complications, so as to improve the quality of life and prolong the survival time.

Transient peripheral blood cytopenia: mainly manifested as peripheral blood leukocytes (neutrophils) and thrombocytopenia. Such as neutrophil absolute count ≤ 0.75 × 109 / L and / or platelet < 50 × 109 / L, IFN should be reduced α Dose; One to two weeks later, if the patient recovered, it gradually increased to the original amount. Such as neutrophil absolute count ≤ 0.5 × 109 / L and / or platelet < 30 × 109 / L, the drug should be stopped. Granulocyte colony-stimulating factor (G-CSF) or granulocyte macrophage colony-stimulating factor (GM-CSF) can be used to treat patients with neutropenia (Ⅲ).

matters needing attention

Proper restriction of fat diet: fat is one of the three major nutrients, and the unsaturated fatty acids it provides are essential nutrients for the body, which can not be replaced by other foods, so it is not necessary to limit it excessively. In addition, the intake of appropriate amount of fat is conducive to the absorption of fat soluble vitamins (such as vitamin A, e, K, etc.). Due to the loss of appetite in patients with chronic hepatitis, gallbladder disease is often associated, and the intake of fatty food is often insufficient. Patients with chronic hepatitis need to eat an appropriate amount of fatty food, but excessive fat restriction is not appropriate. The daily fat supply is generally 40-60g, or about 25% of the total energy. The patients with fatty liver, hyperlipidemia and chronic hepatitis in the acute stage of cholecystitis should be restricted.