Zhang R X, Liu L X
Department of Gastroenterology, The First Hospital of Shanxi Medical University, Taiyuan 030001, China.
Department of Gastroenterology, The First Hospital of Shanxi Medical University, Research and Experimental Centre, Institute of Liver Disease and Organ Transplantation, Taiyuan 030001, China.
Zhonghua Gan Zang Bing Za Zhi. 2022 Oct 20;30(10):1107-1114. doi: 10.3760/cma.j.cn501113-20201007-00541.
To systematically analyze the serological parameters, effective rate and survival rate of patients with liver failure after simple plasma exchange treatment and half-dose plasma exchange combined with dual plasma molecular adsorption system. Randomized controlled trials published in the full-text articles of Pubmed, Embase, Web of Science, The Cochrane Library, Wanfang, Weipu, CNKI, and other journals from June 2020 were retrieved. Revman 5.3 software was used to conduct the meta-analysis after the literature quality evaluation. A total of 10 studies involving 884 cases were selected. Among them, 425 and 459 were treated with combination and simple plasma exchange therapy. The levels of TBIL (=-28.58, 95% : -37.42～-19.75, <0.000 01) and ALB (=-2.00, 95%:-2.61～-1.39, <0.000 01) were lower in the combined treatment group than those in the simple treatment group, and the difference was statistically significant. HGB (=5.96, 95%: 1.52-10.40, =0.009), effective rate (=1.92, 95%: 1.29-2.85, =0.001), and survival rate (=1.63, 95%: 1.13-2.36, =0.009) were higher in the combined treatment group than those in the simple treatment group, and the difference was statistically significant.The two treatment methods had good curative effects for the improvement of ALT, AST, DBIL, PTA, INR, and PLT levels (＜0.05), and there was no statistically significant difference between them (＞0.05). Half-dose plasma exchange combined with dual plasma molecular adsorption system therapy not only effectively improves hyperbilirubinemia, efficacy, and survival rate while significantly reducing plasma dosage, but it also has fewer adverse effects on hemoglobin depletion in patients with liver failure than simple plasma exchange therapy.
系统分析单纯血浆置换治疗与半量血浆置换联合双重血浆分子吸附系统治疗肝衰竭患者的血清学参数、有效率及生存率。检索2020年6月以来发表于Pubmed、Embase、Web of Science、The Cochrane Library、万方、维普、知网等期刊全文中的随机对照试验。采用Revman 5.3软件进行文献质量评价后行Meta分析。共纳入10项研究，涉及884例患者。其中，联合治疗组425例，单纯血浆置换治疗组459例。联合治疗组TBIL水平（=-28.58，95%可信区间：-37.42～-19.75，P＜0.000 01）及ALB水平（=-2.00，95%可信区间：-2.61～-1.39，P＜0.000 01）低于单纯治疗组，差异有统计学意义。联合治疗组HGB水平（=5.96，95%可信区间：1.52～10.40，P=0.009）、有效率（=1.92，95%可信区间：1.29～2.85，P=0.001）及生存率（=1.63，95%可信区间：1.13～2.36，P=0.009）高于单纯治疗组，差异有统计学意义。两种治疗方法对ALT、AST、DBIL、PTA、INR及PLT水平的改善均有良好疗效（P＜0.05），且两组间差异无统计学意义（P＞0.05）。半量血浆置换联合双重血浆分子吸附系统治疗不仅能有效改善高胆红素血症、疗效及生存率，同时显著减少血浆用量，且与单纯血浆置换治疗相比，对肝衰竭患者血红蛋白消耗的不良反应更少。
