血浆置换对慢性乙型重型肝炎患者血清病毒负荷的影响

Influence of Plasma Exchange on the Level of HBV-DNA Content in Patients with Chronic Severe Hepatitis B

【目的】探讨血浆置换对慢性乙型重型肝炎患者血清病毒负荷的影响及其临床意义。【方法】101例慢性乙型重型肝炎患者,分为血浆置换(PE)治疗组和对照组,分别检测血浆置换治疗前后肝功能、乙肝标志物、HBV定量水平;比较死亡组与存活组血浆置换治疗后血清总胆红素和HBV定量水平。【结果】慢性乙型重型肝炎患者PE治疗前肝功能和HBVDNA定量水平明显升高,PE术后肝功能和HBVDNA定量水平有显著下降,同对照组相比差异有显著性(P<0.01);死亡者PE治疗后总胆红素及HBVDNA定量水平同存活者相比差异有显著性(P<0.01)。【结论】PE可明显改善肝功能,降低血清HBVDNA定量水平,对外周血HBV有较强的清除作用。PE术后总胆红素和HBVDNA定量水平可以成为预测重肝治疗效果的一个指标。

[Objective] To observe the influence of plasma exchange（PE） on the level of HBV-DNA content in patients with chronic severe hepatitis B and investigate its clinical significance, [Methods] One hundred and one patients were divided into 2 groups. The treatment group were used by PE in addition to the basic drug treatment, and the control group were only used by the basic drug treatment. Liver function and HBV- DNA content were tested and compared before and after PE, At the same time, liver function and HBV-DNA content between death group and live group were also compared, [Results] Before PE, liver function and HBV-DNA content in patients with chronic severe hepatitis B increased obviously （ P 〈0.01）, compared with those in the healthy people. After PE, liver function and HBV-DNA content decreased obviously （ P 〈0.01）, compared with those in the control group（ P 〈0.01） . The level of TBIL（total bilirubin） and HBV-DNA content were obviously different between death group and live group after PE. [Conclusion]PE can improve liver function and reduce HBV-DNA content in the patients with chronic severe hepatitis B. PE has fairly good effect on clearing hepatitis B virus of peripheral blood. The level of TBIL and HBV-DNA content after PE can become good indexes to forecast the curative effect of patients with chronic severe hepatitis B.