双重血浆分子吸附治疗肝衰竭的临床研究

Clinical research of double plasma molecular absorption system in treatment of liver failure

摘要:

目的 评价双重血浆分子吸附（DPMAS）治疗肝衰竭的疗效及安全性。方法 回顾性分析68例肝衰竭患者的病例资料，根据其治疗方式不同分为DPMAS 组（内科治疗联合DPMAS，39 例）和对照组（内科治疗组，29 例）；分析两组患者治疗前后的临床症状、体征以及血常规、肝肾功能、凝血功能等生化指标，比较分析两组患者的总体疗效、不同病情分期和不同并发症的有效率，记录相关的副作用。结果 与对照组相比，DPMAS 组患者的临床症状好转，总体有效率提高，差异有统计学意义（P <0.05）。DPMAS 可有效改善早期肝衰竭的预后，但对中晚期肝衰竭，疗效不显著，与对照组相比，二者差异无统计学意义（P >0.05）。所有经DPMAS 治疗的患者，未发生电解质紊乱、出血等不良事件，副作用以轻度血压下降为主要表现。结论 DPMAS 可改善肝衰竭患者的临床症状，提高治疗的有效率，尤其对早期肝衰竭治疗效果较好，且无明显副作用，是一种安全有效的人工肝治疗方法。

Abstract:

Objective To assess the efficacy and safety of the double plasma molecular absorption system(DPMAS) in the treatment of liver failure. Methods Clinical materials of 68 patients with severe hepatitis were analyzed retrospectively. According to different therapies, these patients were divided into DPMAS group (39 cases) and control group (29 cases). The patients in the DPMAS group were given DPMAS and medical treatment, those in the control group only received medical treatment. Before and after treatment, the patients' blood was taken to test the changes of biochemical indices, such as ALT, AST, TBIL, DBIL, ALB, PT, WBC, RBC, HB, PLT etc; clinical symptoms and signs were observed. The efficacy of the double plasma molecular absorption system at different stages of severe hepatitis was analyzed, the related side effects were recorded. Results Compared with the control group, the signs and symptoms of the patients in the DPMAS group were improved obviously, and the overall efficacy was also improved, the differences were significant (P < 0.05). A comparison of the two groups revealed that the DPMAS could significantly improve the prognosis of the patients with early liver failure, but did not have obvious effect for the advanced liver failure patients. During DPMAS treatment, no obvious adverse reactions like electrolyte disturbance and bleeding occurred, a mild drop in blood pressure was the main side effect. Conclusions Double plasma molecular absorption system is an effective and safe artificial liver support system to treat severe hepatitis. It has good effect in the early stage of liver failure, but is not effective in the late stage.