双重血浆分子吸附系统联合低量血浆置换治疗慢加急性肝衰竭的临床效果

Clinical effect of dual plasma molecular adsorption system combined with low-dose plasma exchange in the treatment of acute-on-chronic liver failure

目的分析双重血浆分子吸附系统联合低量血浆置换治疗慢加急性肝衰竭的临床效果。方法选取2020年1月至2022年10月收治的99例慢加急性肝衰竭患者作为研究对象,根据治疗方案的不同将其分为A组、B组和C组,各33例。A组给予全量血浆置换治疗,B组给予双重血浆分子吸附系统治疗,C组给予双重血浆分子吸附系统+低量血浆置换治疗。比较三组的治疗效果。结果治疗后,三组的总胆红素(TBIL)、白蛋白(ALB)、丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、肿瘤坏死因子-α(TNF-α)、干扰素γ(IFN-γ)、白细胞介素-10(IL-10)水平均降低,凝血酶原时间(PT)均缩短,纤维蛋白原(FIB)水平均升高,变化程度为C组>B组>A组(P<0.05)。治疗后,三组的终末期肝病模型(MELD)评分均降低,降低程度为C组>B组>A组(P<0.05)。C组的治疗总有效率高于A组、B组,差异具有统计学意义(P<0.05)。结论双重血浆分子吸附系统联合低量血浆置换治疗慢加急性肝衰竭能有效改善患者的实验室指标,提高疗效。

Objective To analyze the clinical effect of dual plasma molecular adsorption system combined with low-dose plasma exchange in the treatment of acute-on-chronic liver failure.Methods A total of 99 patients with acute-on-chronic liver failure admitted from January 2020 to October 2022 were selected as the research objects.According to different treatment schemes,and the patients were divided into group A,group B and group C,with 33 cases in each group.The group A was treated with full-volume plasma exchange,the group B was treated with dual plasma molecular adsorption system,and the group C was treated with dual plasma molecular adsorption system+low-dose plasma exchange.The therapeutic effects of the three groups were compared.Results After treatment,the levels of total bilirubin(TBIL),albumin(ALB),alanine aminotransferase(ALT),aspartate transaminase(AST),tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ),interleukin-10(IL-10)in the three groups decreased,prothrombin time(PT)shortened,and the level of fibrinogen(FIB)increased,the change degree was the group C>the group B>the group A(P<0.05).After treatment,the Model for End-stage Liver Disease(MELD)score of the three groups decreased,and the degree of decrease was the group C>the group B>the group A(P<0.05).The total effective rate of treatment in the group C was higher than that in the group A and group B,and the difference was statistically significant(P<0.05).Conclusion Dual plasma molecular adsorption system combined with low-dose plasma exchange in the treatment of acute-on-chronic liver failure can effectively improve the laboratory indicators of patients and increase the curative effect.