Iwamura Y, Yoshiba M, Sugata F
Department of Medicine, Showa University, Fujigaoka Hospital, Yokohama, Japan.
Nihon Shokakibyo Gakkai Zasshi. 1990 Jan;87(1):109-18.
We treated 10 patients with viral fulminant hepatitis (FH) and subacute hepatitis (SH) by highly reliable artificial liver support (ALS), the combination of plasma exchange (PE) and hemodiafiltration (HDF) using polymethyl methacrylate (PMMA) membrane. All patients regained clear consciousness by the ALS. Even the patients with long term hepatic failure up to for 108 days were sustained in a favorable clinical condition. Five patients finally survived. Interferon was administered to one case with type B FH with positive HBeAg, four cases with NANB FH and SH who were assumed to have persistent viral replication. Two of them showed favorable clinical responses and definite liver regeneration was confirmed. The intensive liver support which can sustain patient with severe fulminant hepatic failure accompanied by the administration interferon is believed to be the most effective treatment for FH and SH especially caused by NANB virus in our country.
我们采用高度可靠的人工肝支持(ALS),即使用聚甲基丙烯酸甲酯(PMMA)膜进行血浆置换(PE)和血液透析滤过(HDF)相结合的方法,治疗了10例病毒性暴发性肝炎(FH)和亚急性肝炎(SH)患者。所有患者通过ALS恢复了清醒意识。即使是长期肝衰竭达108天的患者也维持在良好的临床状态。5例患者最终存活。对1例HBeAg阳性的乙型FH患者、4例被认为存在持续性病毒复制的非甲非乙型FH和SH患者给予了干扰素治疗。其中2例显示出良好的临床反应,并证实有明确的肝再生。我们认为,这种能够维持伴有干扰素治疗的严重暴发性肝衰竭患者生命的强化肝支持,是我国治疗FH和SH尤其是由非甲非乙型病毒引起的FH和SH的最有效治疗方法。