血浆置换联合大黄灌肠对重型肝炎患者血清甲胎蛋白的影响

Influence of plasma exchange combined with rhubarb enema therapy on the serum level of alpha-fetoprotein in patients with severe hepatitis

目的观察血浆置换联合大黄灌肠治疗对重型肝炎患者血清甲胎蛋白(AFP)的影响。方法将收治的76例重型肝炎患者随机分为治疗组36例(A组)及对照组40例(B组)。两组均给予常规内科综合治疗,A组同时给予血浆置换术联合大黄煎剂灌肠治疗,观察两组患者治疗2周后外周静脉血肝功能、血氨、凝血酶原活动度及血清AFP含量的变化情况。结果两组治疗2周后肝功能、血氨、凝血酶原时间等指标较治疗前均显著改善(P<0.01),其中A组改善更显著(P<0.05或P<0.01);两组血清AFP含量治疗2周后均比治疗前显著升高(P<0.01),其中A组改善更明显(P<0.01);治疗组总有效率为80.6%,对照组为57.5%,两组比较差异有统计学意义(χ2=4.661,P<0.05)。结论血浆置换联合大黄灌肠治疗能促进重型肝炎患者肝细胞生长,提高AFP水平,从而提高疗效。

Objective To investigate the effects of plasma exchange combined with rhubarb enema therapy on serum alpha-fetoprotein （AFP） in patients with severe hepatitis. Methods 76 patients undergoing severe hepatitis were randomly divided into 36 cases of treatment group （group A） and 40 cases of control group （group B）. Both groups were administrated with comprehensive medical treatment and group A was administrated with plasma exchange combined with rhubarb decoction enema therapy based on the control group. The liver function and the serum ammonia, prothrombin time （PTA） and AFP were examined in all patients before and after 2 weeks therapy. Results The levels function, PTA and ammonia of two groups were significantly improved than theapy before （P 〈 0.01）, and group A were more significantly improved （P 〈 0.05 or P 〈 0.01）. The levels of serum AFP of two groups were improved obviously after theapy for two weeks （P 〈 0.01）, and group A was more significantly improved （P 〈 0.01）. The total efficiency was 80.6% in the group A and 57.5% in the group B. The total efficiency of the two groups were significant different （χ^2=4.661, P 〈 0.05）. Conclusion Plasma exchange combined with rhubarb enema therapy can promote liver cells of severe hepatitis to grow, increase the level of AFP, and then increase the efficacy.