非生物人工肝对慢性重型肝炎肝功能支持效果评价

Evaluation of the effect of non-bioartificial liver support therapy in patients with chronic severe hepatitis

目的评价非生物人工肝支持治疗对慢性重型肝炎患者肝功能的支持效果及安全性。方法253例早、中、晚期慢性重型肝炎患者在综合治疗基础上给予非生物人工肝支持治疗,观察非生物人工肝支持治疗前后患者肝功能、肾功能、凝血酶原活动度(PTA)、血常规及临床症状变化情况。结果253例慢性重型肝炎患者进行非生物人工肝支持治疗后,血清总胆红素(TBIL)及谷丙转氨酶(ALT)下降,PTA上升(P<0.01);临床症状明显改善率为9.1%,有效率47.8%,总有效率为56.9%,不良反应轻。治疗后中、晚期慢性重型肝炎的存活率分别为53.1%、10.4%,早期患者存活9例。结论非生物人工肝支持治疗慢性重型肝炎患者不良反应轻,对肝功能有肯定的支持作用,尤其对早、中期患者支持效果更好。

Objective To evaluate the clinical efficacy and safety of non-bioartificial liver in the treatment of patients with chronic severe hepatitis. Method A total of 253 patients with chronic severe hepatitis in early, middle and late stages received treatment of non-bioartificial liver. Pre-and post-therapy liver function, renal function, PTA and blood routine test were analyzed, and symptoms of all patients were observed closely. Results After the treatment of non-bioartificial liver, symptoms and manifestation of patients improved. Serum TBIL and ALT decreased, and PTA increased significantly （ P〈0.01 ）. The symptoms in 9.1% of patients improved obviously, and the effective rate was 47.8%. The total effective rate reached 56.9%, and the side effects were mild. The survival rates of patients with chronic severe hepatitis in middle and late stages were 53.1% and 10.4%, respectively. Nine patients in early stage survived. Conclusion The non-bioartificial liver is an effective means for the treatment of chronic severe hepatitis, with mild side effects, especially in early and middle stages.