Di Campli C, Zocco M A, Gaspari R, Novi M, Candelli M, Santoliquido A, Flore R, Tondi P, Proietti R, Gasbarrini G, Pola P, Gasbarrini A
Department of Medical Pathology, Catholic University of Rome, Rome, Italy.
Transplant Proc. 2005 Jul-Aug;37(6):2551-3. doi: 10.1016/j.transproceed.2005.06.040.
The clearance of plasma cytokines by means of albumin dialysis (MARS) has been demonstrated in various studies involving patients affected by either acute liver failure (ALF) or acute on chronic liver failure. The aim of the study was to measure the plasma levels of TNF-alpha, IL-6, and IL-1beta in patients with ALF after each MARS treatment to evaluate the relationship between variations in cytokines levels and patient prognosis.
Ten patients with ALF undergoing several MARS treatments were enrolled (group 1). Blood samples were collected before and after each MARS treatment to measure TNF-alpha, IL-6, and IL-1beta, and other hematochemical parameters. We also enrolled 10 patients with ALF who underwent standard therapy (group 2) as well as a control group of 10 healthy subjects matched for sex and age (group 3).
MARS reduced total bilirubin levels, biliary acids, BUN, ammonia, TNF-alpha, IL-6, and IL-1beta (P < .05). Moreover, the reduction in inflammatory cytokines levels and improved prognosis were related.
We confirmed the therapeutic efficacy of MARS treatment for ALF, which appeared to be related to removal of toxins and inflammatory cytokines determine that which patients prognosis.
在涉及急性肝衰竭（ALF）或慢性肝衰竭急性发作患者的多项研究中，已证实通过白蛋白透析（MARS）清除血浆细胞因子的作用。本研究的目的是测定接受每次MARS治疗后的ALF患者血浆中TNF-α、IL-6和IL-1β的水平，以评估细胞因子水平变化与患者预后之间的关系。
纳入10例接受多次MARS治疗的ALF患者（第1组）。在每次MARS治疗前后采集血样，以测定TNF-α、IL-6和IL-1β以及其他血液生化参数。我们还纳入了10例接受标准治疗的ALF患者（第2组）以及10例年龄和性别匹配的健康受试者作为对照组（第3组）。
MARS降低了总胆红素水平、胆汁酸、BUN、氨、TNF-α、IL-6和IL-1β（P < 0.05）。此外，炎性细胞因子水平的降低与预后改善相关。
我们证实了MARS治疗ALF的疗效，这似乎与毒素和炎性细胞因子的清除有关，而这决定了患者的预后。
