血浆置换对乙型肝炎相关慢加急性肝衰竭的影响：一项横断面研究。
Effect of Plasma Exchange on Hepatitis B-Related Acute-On-Chronic Liver Failure: A Cross-Sectional Study.
作者信息
Wang Lu, Song Lu, Yang Jie
机构信息
Clinical Laboratory, The People's Hospital of Danyang Danyang Hospital Affiliated to Nantong University Danyang Jiangsu China.
出版信息
Health Sci Rep. 2025 Apr 21;8(4):e70729. doi: 10.1002/hsr2.70729. eCollection 2025 Apr.
BACKGROUND
To evaluate the effect of plasma exchange (PE) on the prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF).
METHODS
The basic information (gender, age, blood type), the frequency and dosage of PE, the changes of indicators before and after PE, the adverse reactions related to PE and the prognosis of patients with HBV-ACLF who received PE in our hospital from April 2018 to December 2021 were retrospectively analyzed.
RESULTS
197 patients with HBV-ACLF who underwent PE were included in the analysis. Multivariate analysis shows that blood ammonia, ALBI, bacterial infection rate, HBV-DNA load, MELD score, etc., are independent risk factors affecting the efficacy of PE treatment in HBV-ACLF patients before and after PE treatment.
CONCLUSION
There are many factors influencing the efficacy of plasma exchange in patients with HBV-ACLF. Compared to other factors, high blood ammonia levels and high ALBI are the independent risk factors for poor short-term efficacy of plasma exchange.
背景
评估血浆置换（PE）对乙型肝炎病毒相关慢加急性肝衰竭（HBV-ACLF）患者预后的影响。
方法
回顾性分析2018年4月至2021年12月在我院接受PE治疗的HBV-ACLF患者的基本信息（性别、年龄、血型）、PE的频率和剂量、PE前后指标的变化、与PE相关的不良反应及预后情况。
结果
纳入197例行PE治疗的HBV-ACLF患者进行分析。多因素分析显示，血氨、ALBI、细菌感染率、HBV-DNA载量、MELD评分等是影响HBV-ACLF患者PE治疗前后疗效的独立危险因素。
结论
影响HBV-ACLF患者血浆置换疗效的因素众多。与其他因素相比，高血氨水平和高ALBI是血浆置换短期疗效不佳的独立危险因素。
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