Nakae Hajime, Igarashi Toshiko, Tajimi Kimitaka
Department of Emergency and Critical Care Medicine, Akita University Graduate School of Medicine, Akita, Japan.
Ther Apher Dial. 2012 Oct;16(5):467-71. doi: 10.1111/j.1744-9987.2012.01112.x.
Selective plasma exchange with dialysis is a blood purification therapy in which simple plasma exchange is performed using a selective membrane plasma separator while the dialysate flows out of the hollow fibers. To evaluate the effect of plasma exchange with dialysis, biochemical examination of the blood, for example, the oxidative stress regulation system and interleukin 18 levels, was performed in patients with acute liver failure. We studied four patients with acute liver failure in whom the therapy was performed (nine times in total). The degree of hepatic encephalopathy and interleukin 18 levels decreased significantly after treatment. However, total protein levels did not change significantly. The level of reactive oxygen species and total antioxidant capacity did not change significantly. Plasma exchange with dialysis may be a useful blood purification therapy in cases of acute liver failure in terms of the removal of water-soluble and albumin-bound toxins.
选择性血浆置换联合透析是一种血液净化疗法，即在透析液从空心纤维流出时，使用选择性膜血浆分离器进行单纯血浆置换。为评估血浆置换联合透析的效果，对急性肝衰竭患者进行了血液生化检查，例如氧化应激调节系统和白细胞介素18水平。我们研究了4例接受该治疗的急性肝衰竭患者（总共治疗9次）。治疗后肝性脑病程度和白细胞介素18水平显著降低。然而，总蛋白水平无显著变化。活性氧水平和总抗氧化能力无显著变化。就清除水溶性和白蛋白结合毒素而言，选择性血浆置换联合透析可能是急性肝衰竭病例中一种有用的血液净化疗法。
