糖皮质激素联合DPMAS模式人工肝治疗乙型肝炎病毒所致肝衰竭早期的临床疗效观察

Observation on clinical efficacy of glucocorticoid combined with DPMAS artificial liver in the treatment of hepatitis B-induced early-stage liver failure

目的探讨糖皮质激素联合双重血浆分子吸附(DPMAS)模式人工肝治疗乙型肝炎病毒所致肝衰竭早期的临床疗效。方法90例乙型肝炎病毒所致肝衰竭早期患者,按随机分组法分为治疗组和对照组,各45例。对照组采用糖皮质激素进行治疗,治疗组在对照组的基础上加用DPMAS模式人工肝进行治疗。比较两组丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBil)、凝血酶原时间(PT)、疗效、不良反应发生情况。结果治疗1、2、4、6周后,治疗组ALT、AST、TBil均低于对照组,PT短于对照组,差异有统计学意义(P<0.05)。治疗组治疗总有效率88.89%高于对照组的64.44%,差异有统计学意义(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)。结论糖皮质激素联合DPMAS模式人工肝治疗能明显提高乙型肝炎病毒所致肝衰竭早期患者的治疗效果,且无明显不良反应。

Objective To discuss the clinical efficacy of glucocorticoid combined with dual plasma molecular adsorption system(DPMAS)artificial liver in the treatment of hepatitis B-induced early-stage liver failure.Methods A total of 90 cases of early-stage hepatitis B related liver failure were randomly divided into the treatment group and the control group,with 45 cases in each group.The control group was treated with glucocorticoids,and the treatment group was treated with DPMAS artificial liver in addition to the control group.The alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBil),prothrombin time(PT),efficacy,and occurrence of adverse reactions were compared between the two groups.Results After 1,2,4 and 6 weeks of treatment,the ALT,AST,TBil in the treatment group were lower than those in the control group,and the PT was shorter than that in the control group,and the difference was statistically significant(P<0.05).The total effective rate of treatment in the treatment group was 88.89%,which was higher than 64.44%in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Glucocorticoid combined with DPMAS artificial liver can effectively improve the therapeutic effect of hepatitis B-induced early-stage liver failure without obvious adverse reactions.