Ding Juan, Han Li-Ping, Lou Xiao-Ping, Geng Li-Na, Liu Dong, Yang Qin, Gao Shan
Department of Nursing, First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.
Gynecol Obstet Invest. 2015;79(2):97-100. doi: 10.1159/000368752. Epub 2015 Jan 28.
BACKGROUND/AIMS: Acute fatty liver of pregnancy (AFLP) is a severe liver failure condition that has limited therapeutic approaches. We aimed to evaluate the efficacy of combining plasma exchange (PE) and plasma perfusion (PP) with conventional therapy for the treatment of AFLP using a retrospective analysis.
Among 22 patients with AFLP, 16 cases were treated with conventional treatment (CT group), while the other 6 cases were treated with PE and PP in addition to conventional therapy (CT+PE+PP group). Treatment efficacy was based primarily on survival and secondarily on liver and kidney functions 2 weeks after treatment. Adverse effects were also assessed at the same time point.
In the CT+PE+PP group, 5 (83.3%) patients improved, while 1 (16.7%) patient died of multiple organ dysfunction syndrome. In the CT group, 3 (18.75%) patients improved, while 13 (81.2%) patients died of complications. Liver and kidney functions and survival were significantly improved in the CT+PE+PP group (p < 0.05) compared to the CT group.
Timely application of PE and PP in the early phase of AFLP may be a promising treatment to halt or reverse the progression of AFLP.
背景/目的：妊娠急性脂肪肝（AFLP）是一种严重的肝衰竭疾病，治疗方法有限。我们旨在通过回顾性分析评估血浆置换（PE）和血浆灌注（PP）联合传统疗法治疗AFLP的疗效。
在22例AFLP患者中，16例接受传统治疗（CT组），另外6例在传统治疗基础上联合PE和PP治疗（CT+PE+PP组）。治疗效果主要基于生存率，其次基于治疗后2周的肝肾功能。同时评估不良反应。
CT+PE+PP组中，5例（83.3%）患者病情改善，1例（16.7%）患者死于多器官功能障碍综合征。CT组中，3例（18.75%）患者病情改善，13例（81.2%）患者死于并发症。与CT组相比，CT+PE+PP组的肝肾功能和生存率显著改善（p<0.05）。
在AFLP早期及时应用PE和PP可能是阻止或逆转AFLP进展的一种有前景的治疗方法。
