Bihari D, Hughes R D, Gimson A E, Langley P G, Ede R J, Eder G, Williams R
Int J Artif Organs. 1983 Nov;6(6):299-302.
Resin hemoperfusion using an albumin coated Amberlite XAD-7 column was performed in 19 patients in coma due to fulminant hepatic failure. The procedure was clinically well tolerated, with good blood compatibility, platelet and white cell levels being 97.3 +/- SE 3.2% and 105 +/- 3.8% of the respective initial values after four hours hemoperfusion. No significant changes were observed in beta-thromboglobulin, screen filtration pressure, plasma electrolytes, calcium, protein or albumin. The total plasma bilirubin fell by a mean of 24 mumol/l, with a reduction in 21 of the 25 perfusions studied of up to 104 mumol/l during perfusion. Mean plasma levels of total bile acids were 137 +/- 19 mumol/l and 115 +/- 16 mumol/l respectively before and after four hours hemoperfusion. The amount of bile acids recovered by elution of the resin column was over three times greater than that apparent from the change in plasma levels. Column chromatography on Sephadex G-25 of material eluted from the resin column showed various peaks to be removed, including substances in the middle molecular weight range (1000-5000 daltons). Of the patients treated, eight (42%) survived to leave hospital.
对19例暴发性肝衰竭所致昏迷患者采用涂有白蛋白的Amberlite XAD - 7柱进行树脂血液灌流。该操作在临床上耐受性良好，血液相容性良好，血液灌流4小时后血小板和白细胞水平分别为各自初始值的97.3±标准误3.2%和105±3.8%。β - 血小板球蛋白、筛滤压、血浆电解质、钙、蛋白质或白蛋白均未观察到显著变化。血浆总胆红素平均下降24 μmol/l，在研究的25次灌流中有21次在灌流期间下降高达104 μmol/l。血液灌流4小时前后血浆总胆汁酸平均水平分别为137±19 μmol/l和115±16 μmol/l。通过树脂柱洗脱回收的胆汁酸量比血浆水平变化所显示的量大三倍多。对从树脂柱洗脱的物质进行Sephadex G - 25柱色谱分析显示有多个峰被去除，包括中等分子量范围（1000 - 5000道尔顿）的物质。接受治疗的患者中有8例（42%）存活出院。
