人工肝血浆滤过透析治疗重型肝炎的疗效观察及对血清AFP水平的影响

Efficacy of artificial liver plasma diafiltration on severe hepatitis and its effects on serum AFP level

目的探讨人工肝血浆滤过透析治疗重型肝炎的疗效及对血清AFP水平的影响。方法回顾性分析本院2015年9月至2018年3月收治的120例重型肝炎患者临床资料,根据治疗方式将采取内科综合治疗的患者50例纳入对照组,将在内科综合治疗基础上给予人工肝血浆滤过透析治疗的患者70例纳入观察组,比较两组患者临床转归情况以及治疗前后肝功能、电解质指标、甲胎蛋白水平及并发症发生情况。结果观察组病死率为24.29%,低于对照组的54.00%,差异有统计学意义(P<0.05);观察组患者治疗后谷丙转氨酶(ALT)、谷草转氨酶(AST)、胆红素(TBIL)水平低于对照组,差异有统计学意义(P<0.05);观察组患者治疗后甲胎蛋白(AFP)水平高于对照组,差异有统计学意义(P<0.05);观察组患者治疗后K+、Ca2+水平低于对照组,Na+、Cl-水平高于对照组,差异有统计学意义(P<0.05);观察组患者并发症发生率为1.43%,低于对照组的10.00%,差异有统计学意义(P<0.05)。结论人工肝血浆滤过透析治疗重型肝炎可有效消除患者体内毒素,纠正电解质紊乱,促进肝细胞再生功能,改善患者预后。

Objective To explore the efficacy of artificial liver plasma diafiltration on severe hepatitis and its effects on serum AFP level.Methods The clinical data of 120 patients with severe hepatitis from September 2015 to March 2018 treated in the hospital were retrospectively analyzed. According to the treatment methods, 50 patients with comprehensive medical treatment were included in control group, and 70 patients with artificial liver plasma diafiltration on the basis of comprehensive medical treatment were included in observation group. The clinical outcomes, and the liver function, electrolytes parameters, alpha fetoprotein level and complications before and after treatment were compared between the two groups.Results The mortality rate in observation group was lower than that in control group(24.29% vs. 54.00%)(P<0.05). The levels of alanine aminotransferase(ALT), aspartate aminotransferase(AST) and bilirubin(TBIL) in observation group after treatment were lower than those in control group(P<0.05). The level of alpha fetoprotein(AFP) in observation group after treatment was higher than that in control group(P<0.05). The levels of K+and Ca2+in observation group after treatment were lower than those in control group while the levels of Na+and Cl-were higher than those in control group(P<0.05). The incidence rate of complications in observation group was lower than that in control group(1.43% vs. 10.00%)(P<0.05).Conclusion Artificial liver plasma diafiltration for severe hepatitis can effectively remove vivo toxins, correct electrolyte imbalance, promote liver cell regeneration and improve prognosis of patients.