树脂血液灌流治疗重型肝炎的临床研究

Clinical study of hepatic failure in severe hepatitis treated with hemoperfusion using HA resin

目的回顾分析了HA中性大孔树脂对重型肝炎肝衰竭毒素的清除效果。方法对重庆医科大学附属二院院近期收治的重型肝炎肝衰竭患者40例应用HA中性大孔树脂(HA330-Ⅱ)进行血液灌流治疗,并对再次灌流以后的肝、肾功能以及各类炎性介质做了检测和分析比较。结果①灌流后患者临床症状体征多有不同改善;②灌流后,转氨酶(ALT)、纤维蛋白(TBL)、(DBIL)等明显下降(P<0.01),PTA明显升高(P<0.01);③灌流以后,电解质无明显变化(P>0.05);④灌流后患者白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)明显下降(P<0.01)。结论HA树脂血液灌流治疗能较全面清除重型肝炎患者的肝衰竭毒素,并对临床症状、体征有不同程度改善。

Objective To retrospectively analyze the clearance of toxins in hepatic failure caused by severe hepatitis by hemoperfusion using HA macroporous high molecular absorbent. Methods Forty patients with hepatic failure caused by severe hepatitis were treated with hemoperfusion using HA macroporous resin HA330-？. Their hepatic and renal functions were monitored, and several serum inflammatory markers were measured before and after the treatment. Results After the hemoperfusion, clinical symptoms and signs improved to various extents. ALT, total and direct bilirubin lowered remarkably （P〈0.01）, PTA increased obviously （P〈0.01）, and serum IL-6, and TNF-α decreased significantly. However, serum electrolytes remained unchanged. Conclusions The toxins in hepatic failure caused by severe hepatitis can be efficiently cleared by the hemoperfusion using HA resin as the adsorbent. After the hemodialysis, patients＇ clinical symptoms and signs improved to various extents.