血浆置换并胆红素吸附治疗肝衰竭的效果

EFFECT OF COTHERAPY WITH PLASMA EXCHANGE AND PLASMA BILIRUBIN ADSORPTION ON LIVER FAILURE

目的观察血浆置换(PE)并胆红素吸附(PBA)治疗肝衰竭的临床效果。方法肝衰竭病人164例,随机分为PE组、PE并PBA组,观察治疗前后两组病人丙氨酸转氨酶(ALT)、总胆红素(TBIL)、清蛋白(ALB)、凝血酶原时间活动度(PTA)的变化,并观察两组病人不良反应的发生率。结果两组病人ALT、TBIL治疗后均明显低于治疗前(t=6.33~13.32,P<0.05);两组ALT、TBIL治疗前后差值比较,差异有显著性(t=2.78、3.85,P<0.05)。两组ALB及PTA治疗后明显高于治疗前(t=-7.33^-2.27,P<0.05);但两组ALB及PTA治疗前后差值比较,差异无显著性(P>0.05)。两组均未发生严重不良反应。结论 PE及PE并PBA治疗肝衰竭有效,且PE并PBA清除体内TBIL、ALT效果优于单纯PE治疗,且不良反应发生率低。

Objective To investigate clinical efficacy of plasma exchange （PE） combined with plasma bilirubin adsorption （PBA） in the treatment of liver failure. Methods This study consisted of 164 patients with liver failure and randomized to PE group and PE＋PBA group. Serum alanine aminotransferase （ALT）, total bilirubin （TBIL）, albumin （ALB）, and prothrombin time activity （PTA） were observed in the two groups, before and after treatmen. The incidence of adverse reactions was observed. Results After treatment, ALT and TBIL in both groups were much lower than before （t =6.33-13.32,P〈0.05）, the differ- ences in ALT and TBIL in two groups between before and after treatment were significant （t = 2.78,3.85;P〈0.05）. After treat- ment, the levels of ALB and PTA were higher than before in both groups （t = -7.33--2.27, P 〈0.05）, but the differences of ALB and PTA between the two groups were not significant （P〉0.05）. No serious adverse reactions were noted in both groups. Conclusion Both plasma exchange and plasma exchange combined with plasma bilirubin adsorption are effective for liver failure, but the latter is better than the former in removing TBIL and ALT, and the adverse reaction rate is lower as well.