非生物型组合人工肝治疗急性肝衰竭实验研究

An Experimental Study of Combined Nonbioartificial Liver for Pigs with Acute Hepatic Failure

目的：建立大型动物急性肝功能衰竭动物模型，用来评价非生物型组合人工肝治疗效果。方法：将中国实验小型猪28头随机分为对照组（n=13）与治疗组（n=15），应用D-氮基半乳糖1．2g／kg静脉注射诱导建立急性肝衰竭动物模型。给药48小时后治疗组给予血浆置换联合血液滤过治疗，对照组未实行任何干预措施。观察比较两组动物生存时间、生化指标、颅内压与病理变化。结果：治疗组的生存时间较对照组明显延长，两组分别为128．7±11．3小时和67．9±9．4小时（P〈0．01），治疗组多项生化指标、炎性细胞因子、颅内压、组织病理等都比同期非治疗组动物有不同程度改善（P〈0．05～0．01）。结论：血浆置换联合血液滤过的非生物型组合人工肝治疗，能显著延长急性肝衰实验动物生存时间，降低颅内压，改善生化、病理指标与近期预后，可作为肝脏移植和药物治疗的有效辅助手段。

Objective：To evaluate the efficacy of combined nonbioartificial liver （plasma exchange plus continuous hemofiltration）for large animal model of fulminant hepatic failure induced by D-galactosamine. Methods ：28 pigs were divided into two groups at random：control group（ n = 13 ） and treatment group（ n = 15 ）. All of the animals were inducced fulminant hepatic failure with administration of D-galactosamlne firstly. 48 hours later the treatment group was treated with PE combined with CHF for 12 hours. Efficacy was assessed by comparing the survival time,improvement in manifestation, biochemical and pathological parameters. Results： The treatment group＇s mean survival time was 128.7 ± 11.3 hours, which was much longer than in tile control group 67.9 ± 9.4 hours （ p 〈 0.01 ）. There were significant differences for serum bilirubin, aminotransferase, ICP, ammonia, prothrombin time and histological manifestation between the two groups at the same time. Conclusion：Combined nonbioartifical liver （PE plus CHF） was effective for fulminant hepatic failure,and may be as a good bridging measure for liver transplantation and other method.