双重血浆分子吸附系统联合血液滤过治疗慢加急性肝衰竭的疗效分析

Effect of double plasma molecular adsorption system combined with hemofiltration on acute-on-chronic liver failure

目的探讨双重血浆分子吸附系统(DPMAS)联合血液滤过(HF)治疗慢加急性肝衰竭(ACLF)的疗效。方法回顾性选取63例ACLF患者,分为观察组(n=33)和对照组(n=30)。对照组给予血浆置换(PE)联合HF,观察组给予DPMAS联合HF。对比两组总胆红素(TBiL)、直接胆红素(DBil)、丙氨酸氨基转移酶(ALT)、凝血酶原时间(PT)、凝血酶原活动度(PTA)、血清白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平;统计两组临床疗效及不良反应发生率。结果治疗后,观察组TBiL、DBil、ALT均显著低于对照组(P<0.05),两组PTA、PT比较差异无统计学意义(P>0.05)。观察组IL-6、TNF-α及CRP均显著低于对照组(P<0.05)。观察组临床疗效显著优于对照组(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论DPMAS联合HF治疗ACLF患者的效果优于PE联合HF,可明显降低血清炎症因子水平,促进肝功能恢复,提高临床疗效。

Objective To evaluate the effect of double plasma molecular adsorption system(DPMAS)combined with hemofiltration(HF)on acute-on-chronic liver failure(ACLF).Methods 63 ACLF patients were divided into observation group(n=33)and control group(n=30).The control group was given to plasma exchange(PE)combined with HF,and the observation group was given to DPMAS combined with HF.The total bilirubin(TBiL),direct bilirubin(DBil),alanine aminotransferase(ALT),prothrombin time(PT),prothrombin activity(PTA),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),clinical efficacy and adverse reaction were compared between the two groups.Results After treatment,the TBiL,DBil and ALT of observation group were significantly less than those of control group(P<0.05),PTA and PT of two groups were no statistical difference(P<0.05).The IL-6,TNF-αand CRP of observation group were significantly less than those of control group(P<0.05).The clinical efficacy of observation group were significantly better than control group(P<0.05).There was no statistical difference in adverse reactions incidence between two groups(P>0.05).Conclusion DPMAS combined with HF is superior to PE combined with HF,which can significantly reduce serum inflammatory factors level of ACLF patients,promote liver function recovery,and improve clinical efficacy.