血液灌流吸附和/或血浆置换治疗重型病毒性肝炎的效果：一项对比研究。
Effects of hemoperfusion adsorption and/or plasma exchange in treatment of severe viral hepatitis: a comparative study.
作者信息
He Nian-Hai, Wang Ying-Jie, Wang Ze-Wen, Liu Jun, Li Jia-Jia, Liu Guo-Dong, Wang Yu-Ming
机构信息
Research Institute of Infectious Disease, Southwest Hospital, Third Military Medical University, 29 Gaotanyan Zhengjie, Chongqing 400038, China.
出版信息
World J Gastroenterol. 2004 Apr 15;10(8):1218-21. doi: 10.3748/wjg.v10.i8.1218.
AIM
Non-bioartificial liver has been applied to clinic for quite a long time, but the reported efficacy has been very different. The aim of this study was to compare the efficacy and safety of hemoperfusion adsorption, plasma exchange and plasma exchange plus hemoperfusion adsorption in treatment of severe viral hepatitis.
METHODS
Seventy-five patients with severe viral hepatitis were treated with hemoperfusion adsorption therapy (24 cases), plasma exchange therapy (17 cases) and plasma exchange plus hemoperfusion adsorption therapy (34 cases). The data of liver function, renal function, blood routine test, prothrombin time (PT) and prothrombin activity (PTa) pre- and post-therapy were analyzed.
RESULTS
Clinical symptoms of patients improved after treatment. The levels of aminotransferase, total bilirubin, direct bilirubin decreased significantly after 3 therapies (P<0.05 or P<0.01). PT, the level of total serum protein decreased significantly and PTa increased significantly after plasma exchange therapy and plasma exchange plus hemoperfusion adsorption therapy (P<0.05 or P<0.01). The side effects were few and mild in all patients.
CONCLUSION
Three therapies were effective in the treatment of severe viral hepatitis. Plasma exchange therapy and plasma exchange plus hemoperfusion adsorption therapy are better than hemoperfusion adsorption therapy.
目的
非生物人工肝应用于临床已有相当长的时间，但报道的疗效差异很大。本研究旨在比较血液灌流吸附、血浆置换以及血浆置换联合血液灌流吸附治疗重型病毒性肝炎的疗效和安全性。
方法
75例重型病毒性肝炎患者分别接受血液灌流吸附治疗（24例）、血浆置换治疗（17例）和血浆置换联合血液灌流吸附治疗（34例）。分析治疗前后患者的肝功能、肾功能、血常规、凝血酶原时间（PT）和凝血酶原活动度（PTa）数据。
结果
治疗后患者临床症状改善。三种治疗后谷丙转氨酶、总胆红素、直接胆红素水平均显著下降（P<0.05或P<0.01）。血浆置换治疗以及血浆置换联合血液灌流吸附治疗后PT、血清总蛋白水平显著下降，PTa显著升高（P<0.05或P<0.01）。所有患者副作用少且轻微。
结论
三种治疗方法对重型病毒性肝炎均有效。血浆置换治疗以及血浆置换联合血液灌流吸附治疗优于血液灌流吸附治疗。
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