血浆置换治疗异基因造血干细胞移植后高胆红素血症的临床分析

Clinical Analysis of Plasma Exchange Treatment of Hyperbilirubinemia after Allogeneic Hematopoietic Stem Cell Transplantation

目的探讨血浆置换对异基因造血干细胞移植(allo-HSCT)后高胆红素血症的疗效。方法采用血浆置换治疗allo-HSCT后发生高胆红素血症患者9例(共16例次)。比较治疗前后肝脏功能、凝血酶原时间、血常规等指标,同时观察不良反应。结果 9例患者共进行16次血浆置换治疗。血浆置换治疗后,血清总胆红素、直接胆红素明显下降,血细胞、白蛋白、凝血酶原时间变化差异无显著性(P>0.05)。结论血浆置换治疗能够在一定程度上降低血清胆红素,对预后的影响仍需进一步研究。

Objective To analyze the therapeutic effect of plasma exchange(PE) in the treatment of hyperbilirubinemia after allo-HSCT. Method From October 2009 to October 2016,nine patients(16 events altogether) received PE due to hyperbilirubinemia after allo-HSCT. The liver function, bilirubin and prothrombin time activity were compared before and after the treatment. Adverse effects were observed in the same time. Result All 9 patients were treated with plasma exchange totally 16 times; After the treatment,serum total bilirubin(TB) and direct bilirubin( DB)decreased. The decreased levels in blood cells, albumin and prothrombin time activity were not statistically significant. Conclusion Plasma exchange therapy may reduce the serum bilirubin level in a certain extent. But the effect of plasma exchange on prognosis remains to be further studied.