双重血浆分子吸附系统治疗肝功能衰竭的临床优势和安全性研究

Clinical Advantages and Safety of Double Plasma Molecular Adsorption System in the Treatment of Liver Failure

目的:比较血浆置换和双重血浆分子吸附系统(DPMAS)治疗肝功能衰竭患者,对肝功能的改善作用及安全性。方法:选择60例肝衰竭患者,随机将患者分为血浆置换组(A组)和双重血浆吸附组(B组),每组30例,分别应用血浆置换治疗、DPMAS治疗。评估主要症状体征变化、临床疗效、安全性,检测治疗前后血清相关指标。结果:A组和B组治疗效果比较,差异无统计学意义(P>0.05)。B组治疗后ALT、TBIL、TBA、ALB、PTA均优于A组,差异均有统计学意义(P<0.05);B组患者治疗后血氨、血清内毒素、TNF-α、IL-6、不良反应总发生率分别为(86.53±10.21)mmol/L、(0.76±0.25)EU/ml、(52.45±7.14)ng/ml、(41.33±5.38)pg/ml、16.67%,均低于A组,差异均有统计学意义(P<0.05)。结论:DPMAS模式可改善肝脏功能,并在清除血氨、血清内毒素、TNF-α和IL-6等方面的优势更加明显。

Objective:To compare plasma exchange and dual plasma molecular adsorption system(DPMAS)in the treatment of patients with liver failure,to improve liver function and safety.Method:A total of 60 patients with liver failure were randomly divided into the plasma exchange group(group A)and the dual plasma adsorption group(group B)according to the random number table method,30 cases in each group,respectively given plasma exchange therapy and DPMAS treatment.Evaluated changes in main symptoms and signs,clinical efficacy,and safety,detect serum-related indicators before and after treatment.Result:There was no significant difference of the clinical effect between the group A and group B(P>0.05).After treatment,the levels of ALT,TBIL,TBA,ALB and PTA of the group B were better than those of the group A,the differences were statistically significant(P<0.05).The blood ammonia,serum endotoxin,TNF-αand IL-6 and total incidence of adverse reactions of the group B were(86.53±10.21)mmol/L,(0.76±0.25)EU/ml,(52.45±7.14)ng/ml,(41.33±5.38)pg/ml,16.67%,lower than those of the group A,the differences were statistically significant(P<0.05).Conclusion:DPMAS mode can improve liver function,and has more obvious advantages in removing blood ammonia,serum endotoxin,TNF-αand IL-6.