TECA型组合型人工肝系统治疗肝功能衰竭患者的初步临床观察

Initial clinic report of TECA-hybrid artificial liver support system to treat patients with acute liver failure

目的 :观察TECA型组合型人工肝支持系统 (HALSS)治疗急性肝功能衰竭 (ALF)患者的有效性和安全性。方法 :分离中国实验用小型猪肝细胞并培养于BALSS的生物反应器中。患者的血浆先经碳吸附或血浆置换后 ,循环流经BALSS的中空纤维管。每次治疗持续 6～ 7h。观察治疗前、后患者生理和血液生化指标的变化。结果 :从每只小型猪的肝脏平均可得到 (1.0～ 3.0 )× 10 10 个猪肝细胞 ,存活率 >85 %。TECA -HALSS治疗结束后 ,患者的血NH3、ALT、AST、TB、DB等水平明显降低 ;PTA水平升高 ;患者的神志由嗜睡或昏迷转为清醒。治疗中患者生命体征平稳、血电解质水平无明显改变。结论 :TECA -HALSS是一种能迅速、安全。

Objective:To assess the efficacy and safety of type TECA hybrid artificial liver support system (HALSS) to treat patients with acute liver failure (ALF).Methods:The primary hepatocytes were separated from the swine and cultured within the bioreactor of HALSS.First,the plasma of the patients was treated by charcoal sorbent or plasma exchange,then flew through the HALSS for moderate and small molecular weight substances exchanges.Each treatment lasted 6.0～7.0 hours.Observed the changes of physiological and blood biochemical parameters before and after the treatment.Results:Using our modified enzymatic digestion method,the yield of hepatocytes was (1.0～3.0)×10 10 from perswine with high viability.Type TECA-HALSS treatment resulted in beneficial effects with the levels of plasma NH 3,ALT,AST,TB and DB decreased,the level of PTA ascended.The mentality of the patients turned from coma to consciousness.All patients tolerated the procedure well,the vital signs well stable.No obvious side effects were found during the treatment.Conclusion:Type TECA-HALSS is rapid,safe and efficacious in providing temporary liver support in patients with ALF,so it would hopefully be a new method in the treatment of ALF.