血浆置换联合双血浆分子吸附系统对3~4级药物性肝损伤的疗效

An analysis on the effect of plasma exchanges combined with dual plasma molecular adsorption system in the treatment of drug-induced liver failure

目的评估血浆置换(PE)和双血浆分子吸附系统(DPMAS)联合治疗3~4级药物性肝损伤患者的效果。方法回顾性分析岳阳市中心医院2020年6月至2021年2月接诊的64例3~4级药物性肝损伤患者的临床资料。其中PE联合DPMAS治疗32例,单纯药物治疗32例。对比治疗前后两组临床疗效、TBil、ALT、AST、凝血功能指标(PT)的变化,并对不良临床反应的发生情况进行记录。结果PE联合DPMAS组的总有效率为87.5%(28/32),比单纯药物组的65.6%(21/32)明显提高。PE联合DPMAS组在降低胆红素和提高凝血功能(P值分别为0.017和0.025)方面有更好的表现,而两组治疗后转氨酶比较差异无统计学意义(P值分别为0.497和0.103)。两组不良事件发生率无明显差异。结论采用PE联合DPMAS治疗3~4级药物性肝损伤疗效确切,安全性高。

Objective To explore the efficacy of plasma exchange(PE)combined with dual plasma molecular adsorption system(DPMAS)in the treatment of patients with drug-induced liver failure.Methods A retrospective analysis was conducted on 64 patients with drug-induced liver failure(grade 3 to 4 of drug-induced liver injury)admitted to the department of infectious diseases of Yueyang Central Hospital from June 2020 to February 2021.Among them,32 were in the PE combined with DPMAS treatment group and 32 were in the drug treatment alone group.Results The clinical efficacy of the two groups post-treatment,the alterations in liver function and coagulation function indicators pre-and post-treatment,as well as the incidence of clinical adverse reactions were compared.The combined use of PE and DPMAS group yielded a significantly higher total effective rate(87.5%)than that of the drug alone group(65.6%).PE combined with DPMAS group had more advantages in reducing bilirubin and improving blood coagulation function(P=0.017 and 0.025,respectively),and there was no statistical difference between the two groups in reducing glutamic pyruvic transaminase and glutamic oxalic transaminase(P=0.497 and 0.103,respectively).Conclusion The incidence of adverse reactions was not significantly different between the two groups.The utilization of both plasma exchange and dual plasma molecular adsorption system is a safe and effective treatment for individuals suffering from drug-induced liver failure.