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Effect of extracorporeal bioartificial liver support system on fulminant hepatic failure rabbits 被引量:17
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作者 Wang YJ Li MD +3 位作者 Wang YM Chen GZ Lu GD Tan ZX 《World Journal of Gastroenterology》 SCIE CAS CSCD 2000年第2期252-254,共3页
AIM To evaluate the possibility of usingcultured human hepatocytes as a bridge betweenbioartificial liver and liver transplantation.METHODS In this experiment,the efficacy ofextracorporeal bioartificial liver support ... AIM To evaluate the possibility of usingcultured human hepatocytes as a bridge betweenbioartificial liver and liver transplantation.METHODS In this experiment,the efficacy ofextracorporeal bioartificial liver support system(EBLSS)consisting of spheriodal human livercells and cultured hepatocytes supernatant wasassessed in vivo using galactosamine inducedrabbit model of fulminant hepatic failure.RESULTS There was no difference of survivalbetween the two groups of rabbits,but in thesupported rabbits serum alanineaminotransferase,total bilirubin and creatininewere significantly lower and hepatocyte necrosiswas markedly milder than those in controlanimals.In addition,a good viability of humanliver cells was noted after the experiment.CONCLUSION EBLSS plays a biologic role inmaintaining and compensating the function ofthe liver. 展开更多
关键词 artificial liver liver support FULMINANT hepatic failure RABBIT
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Efficacy of liver transplantation for acute hepatic failure:asingle-center experience 被引量:2
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作者 Xian-Jie Shi,Hong-Bin Xu,Wen-Bin Ji,Yu-Rong Liang,Wei-Dong Duan,Lei He,Ming-Jun Wang and Zhi-Ming Zhao Department of Hepatobiliary Surgery Department of Anesthesiology General Hospital of PLA,Beijing 100853,China 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS 2011年第4期369-373,共5页
BACKGROUND:Acute hepatic failure (AHF) is a devastating clinical syndrome with a high mortality rate.The outcome of AHF varies with etiology,but liver transplantation (LT) can significantly improve the prognosis and s... BACKGROUND:Acute hepatic failure (AHF) is a devastating clinical syndrome with a high mortality rate.The outcome of AHF varies with etiology,but liver transplantation (LT) can significantly improve the prognosis and survival rate of such patients.This study aimed to detect the role of LT and artificial liver support systems (ALSS) for AHF patients and to analyze the etiology and outcome of patients with this disease.METHODS:A retrospective analysis was made of 48 consecutive patients with AHF who fulfilled the Kings College Criteria for LT at our center.We analyzed and compared the etiology,outcome,prognosis,and survival rates of patients between the transplantation (LT) group and the non-transplantation (N-LT) group.RESULTS:AHF was due to viral hepatitis in 25 patients (52.1%;hepatitis B virus in 22),drug or toxic reactions in 14 (29.2%;acetaminophen in 6),Wilson disease in 4 (8.3%),unknown reasons in 3 (6.3%),and miscellaneous conditions in 2 (4.2%).In the LT group,36 patients (7 underwent living donor LT,and 29 cadaveric LT) had an average model for endstage liver disease score (MELD) of 35.7.Twenty-eight patients survived with good graft function after a follow-up of 27.3± 4.5 months.During the waiting time,6 patients were treated with ALSS and 2 of them died during hospitalization.The 30-day,12-month,and 18-month survival rates were 77.8%,72.2%,and 66.7%,respectively.In the N-LT group,12 patients had an average MELD score of 34.5.Four patients were treated with ALSS and all died during hospitalization.The 90-day and 1-year survival rates were only 16.7% and 8.3%,respectively.CONCLUSIONS:Hepatitis is the most prominent cause of AHF at our center.Most patients with AHF,who fulfill the Kings College Criteria for LT,did not survive longer without LT.ALSS did not improve the prognosis of AHF patients,but may extend the waiting time for a donor.Currently,LT is still the most effective way to improve the prognosis of AHF patients. 展开更多
关键词 acute hepatic failure liver transplantation artificial liver support PROGNOSIS survival rate ETIOLOGY
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An interpretability model for syndrome differentiation of HBV-ACLF in traditional Chinese medicine using small-sample imbalanced data
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作者 ZHOU Zhan PENG Qinghua +3 位作者 XIAO Xiaoxia ZOU Beiji LIU Bin GUO Shuixia 《Digital Chinese Medicine》 CAS CSCD 2024年第2期137-147,共11页
Objective Clinical medical record data associated with hepatitis B-related acute-on-chronic liver failure(HBV-ACLF)generally have small sample sizes and a class imbalance.However,most machine learning models are desig... Objective Clinical medical record data associated with hepatitis B-related acute-on-chronic liver failure(HBV-ACLF)generally have small sample sizes and a class imbalance.However,most machine learning models are designed based on balanced data and lack interpretability.This study aimed to propose a traditional Chinese medicine(TCM)diagnostic model for HBV-ACLF based on the TCM syndrome differentiation and treatment theory,which is clinically interpretable and highly accurate.Methods We collected medical records from 261 patients diagnosed with HBV-ACLF,including three syndromes:Yang jaundice(214 cases),Yang-Yin jaundice(41 cases),and Yin jaundice(6 cases).To avoid overfitting of the machine learning model,we excluded the cases of Yin jaundice.After data standardization and cleaning,we obtained 255 relevant medical records of Yang jaundice and Yang-Yin jaundice.To address the class imbalance issue,we employed the oversampling method and five machine learning methods,including logistic regression(LR),support vector machine(SVM),decision tree(DT),random forest(RF),and extreme gradient boosting(XGBoost)to construct the syndrome diagnosis models.This study used precision,F1 score,the area under the receiver operating characteristic(ROC)curve(AUC),and accuracy as model evaluation metrics.The model with the best classification performance was selected to extract the diagnostic rule,and its clinical significance was thoroughly analyzed.Furthermore,we proposed a novel multiple-round stable rule extraction(MRSRE)method to obtain a stable rule set of features that can exhibit the model’s clinical interpretability.Results The precision of the five machine learning models built using oversampled balanced data exceeded 0.90.Among these models,the accuracy of RF classification of syndrome types was 0.92,and the mean F1 scores of the two categories of Yang jaundice and Yang-Yin jaundice were 0.93 and 0.94,respectively.Additionally,the AUC was 0.98.The extraction rules of the RF syndrome differentiation model based on the MRSRE method revealed that the common features of Yang jaundice and Yang-Yin jaundice were wiry pulse,yellowing of the urine,skin,and eyes,normal tongue body,healthy sublingual vessel,nausea,oil loathing,and poor appetite.The main features of Yang jaundice were a red tongue body and thickened sublingual vessels,whereas those of Yang-Yin jaundice were a dark tongue body,pale white tongue body,white tongue coating,lack of strength,slippery pulse,light red tongue body,slimy tongue coating,and abdominal distension.This is aligned with the classifications made by TCM experts based on TCM syndrome differentiation and treatment theory.Conclusion Our model can be utilized for differentiating HBV-ACLF syndromes,which has the potential to be applied to generate other clinically interpretable models with high accuracy on clinical data characterized by small sample sizes and a class imbalance. 展开更多
关键词 Traditional chinese medicine(TCM) Hepatitis B-related acute-on-chronic liver failure(HBV-ACLF) Imbalanced data Random forest(RF) INTERPRETABILITY
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Experimental study of bioartificial liver with cultured human liver cells 被引量:14
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作者 WANG Ying Jie, LI Meng Dong, WANG Yu Ming, NIE Qing He and CHEN Guo Zheng 《World Journal of Gastroenterology》 SCIE CAS CSCD 1999年第2期47-49,共3页
AIM To establish an extracorporeal bioartificial liver support system (EBLSS) using cultured human liver cells and to study its support effect for fulminant hepatic failure (FHF).METHODS The liver support experiment o... AIM To establish an extracorporeal bioartificial liver support system (EBLSS) using cultured human liver cells and to study its support effect for fulminant hepatic failure (FHF).METHODS The liver support experiment of EBLSS consisting of aggregates cultured human liver cells, hollow fiber bioreactor, and circulation unit was carried out in dizhepatic dogs.RESULTS The viability of isolated hepatocytes and nonparenchymal liver cells reached 96%. These cells were successfully cultured as multicellular spheroids with synthetic technique. The typical morphological appearance was retained up to the end of the artificial liver experiment. Compared with the control dogs treated with EBLSS without liver cells, the survival time of artificial liver support dogs was significantly prolonged. The changes of blood pressure, heart rate and ECG were slow. Both serum ammonia and lactate levels were significantly lowered at the 3rd h and 5th h. In addition, a good viability of human liver cells was noted after 5 h experiment.CONCLUSION EBLSS playing a metabolic role of cultured human hepatocytes, is capable of compensating the function of the liver, and could provide effective artificial liver support and therapy for patients with FHF. 展开更多
关键词 artificial liver cell CULTURED HEPATOCYTES FULMINANT hepatic failure ANIMAL model liver support
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Progress in hepatitis B virus-related acute-on-chronic liver failure treatment in China:A large,multicenter,retrospective cohort study using a propensity score matching analysis 被引量:8
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作者 Lan-Lan Xiao Xiao-Xin Wu +5 位作者 Jia-Jia Chen Dong Yan Dong-Yan Shi Jian-Rong Huang Xiao-Wei Xu Lan-Juan Li 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2021年第6期535-541,共7页
Background:Hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF)has a high short-term mortality.However,the treatment progression for HBV-ACLF in China in the past decade has not been well characterized.T... Background:Hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF)has a high short-term mortality.However,the treatment progression for HBV-ACLF in China in the past decade has not been well characterized.The present study aimed to determine whether the HBV-ACLF treatment has significantly improved during the past decade.Methods:This study retrospectively compared short-term(28/56 days)survival rates of two different nationwide cohorts(cohort I:2008-2011 and cohort II:2012-2015).Eligible HBV-ACLF patients were enrolled retrospectively.Patients in the cohorts I and II were assigned either to the standard medical therapy(SMT)group(cohort I-SMT,cohort II-SMT)or artificial liver support system(ALSS)group(cohort IALSS,cohort II-ALSS).Propensity score matching analysis was conducted to eliminate baseline differences,and multivariate logistic regression analysis was used to explore the independent factors for 28-day survival.Results:Short-term(28/56 days)survival rates were significantly higher in the ALSS group than those in the SMT group(P<0.05)and were higher in the cohort II than those in the cohort I(P<0.001).After propensity score matching,short-term(28/56 days)survival rates were higher in the cohort II than those in the cohort I for both SMT(60.7%vs.53.0%,50.0%vs.39.8%,P<0.05)and ALSS(66.1%vs.56.5%,53.0%vs.44.4%,P<0.05)treatments.The 28-day survival rate was higher in patients treated with nucleos(t)ide analogs than in patients without such treatments(P=0.046).Multivariate logistic regression analysis revealed that ALSS(OR=0.962,95%CI:0.951-0.973,P=0.038),nucleos(t)ide analogs(OR=0.927,95%CI:0.871-0.983,P=0.046),old age(OR=1.028,95%CI:1.015-1.041,P<0.001),total bilirubin(OR=1.002,95%CI:1.001-1.003,P=0.004),INR(OR=1.569,95%CI:1.044-2.358,P<0.001),COSSH-ACLF grade(OR=2.683,95%CI:1.792-4.017,P<0.001),and albumin(OR=0.952,95%CI:0.924-0.982,P=0.002)were independent factors for 28-day mortality.Conclusions:The treatment for patients with HBV-ACLF has improved in the past decade. 展开更多
关键词 Hepatitis B virus-related acute-on-chronic liver failure Propensity score matching analysis Short-term survival rate Standard medical therapy artificial liver support system
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The “Traditional Chinese medicine regulating liver regeneration” treatment plan for reducing mortality of patients with hepatitis B-related liver failure based on real-world clinical data 被引量:7
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作者 Ling Dai Xiang Gao +4 位作者 Zhihua Ye Hanmin Li Xin Yao Dingbo Lu Na Wu 《Frontiers of Medicine》 SCIE CSCD 2021年第3期495-505,共11页
On the basis of real-world clinical data,the study aimed to explore the effect and mechanisms of the treatment plan of“traditional Chinese medicine(TCM)regulating liver regeneration.”A total of 457 patients with HBV... On the basis of real-world clinical data,the study aimed to explore the effect and mechanisms of the treatment plan of“traditional Chinese medicine(TCM)regulating liver regeneration.”A total of 457 patients with HBV-related liver failure were retrospectively collected.The patients were divided into three groups:the modern medicine control group(MMC group),patients treated with routine medical treatment;the control group combining traditional Chinese and Western medicine(CTW),patients treated with routine medical treatment plus the common TCM formula;and the treatment group of“TCM regulating liver regeneration”(RLR),patients treated with both routine medical treatment and the special TCM formula of RLR.After 8 weeks of treatment,the mortality of patients in the RLR group(12.31%)was significantly lower than those in the MMC(50%)and CTW(29.11%)groups.Total bilirubin level significantly decreased and albumin increased in the RLR group when compared with the MMC and CTW groups(P<0.05).In addition,there were significant differences in the expression of several cytokines related to liver regeneration in the RLR group compared with the MMC group.RLR treatment can decrease jaundice,improve liver function,and significantly reduce the mortality in patients with HBV-related liver failure.The mechanism may be related to the role of RLR treatment in influencing cytokines related to liver regeneration. 展开更多
关键词 hepatitis B virus-related liver failure traditional chinese medicine liver regeneration liver regeneration microenvironment CYTOKINES
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Distribution of Traditional Chinese Medicine patterns in 324 cases with hepatitis B-related acute-on-chronic liver failure:a prospective,cross-sectional survey 被引量:7
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作者 Xiaoyu Hu Yang Zhang +2 位作者 Guo Chen Yibei Li Sen Zhong 《Journal of Traditional Chinese Medicine》 SCIE CAS CSCD 2012年第4期538-544,共7页
OBJECTIVE: To determine the distribution of Tradi- tional Chinese Medicine (TCM) patterns in hepatitis B-related acute-on-chronic liver failure (HB-ACLF) in different stages for guiding clinical prescriptions and... OBJECTIVE: To determine the distribution of Tradi- tional Chinese Medicine (TCM) patterns in hepatitis B-related acute-on-chronic liver failure (HB-ACLF) in different stages for guiding clinical prescriptions and treatments. METHODS: A prospective, cross-sectional survey method was used in this study. A total of 324 cases with HB-ACLF in China were involved. RESULTS: The general frequency of TCM patterns in HB-ACLF were as follows: Heat Toxin Stagnation Pattern (134/324, 41.36%), Damp-heat Obstruction Pattern (66/324, 20.37% ), Yong Qi Deficiency Pat- tern (52/324, 16.05%), and Liver and Kidney Yin De- ficiency Pattern (26/324, 8.02%). In the early stage of HB-ACLE there was a remarkably higher percent- age of excessive patterns than those in the middle and late stage. The incidence of Heat Toxin Stagna- tion reached 58.57% (82/140) in the early stage, while it was 33.96% (36/106) in the middle stage and 20.51% (16/78) in the late stage. In the early stage of HB-ACLF, excessive patterns, such as the Heat Toxin Stagnation Pattern, were more preva- lent than those in the middle and late stages (P〈a'= 0.003). However, in the late stage of HB-ACLE defi- cient patterns, such as the Yang Qi Deficiency Pat- tern, were more prevalent than those in the early and middle stages. The Yang Qi Deficiency Pattern had a higher rate of 41.03% (32/78) in the late stage compared with that of 20.75% (22/106) in the middle stage and 8.57% (12/140, P〈a' =0.003) in the early stage. The distribution of the other pat- terns was not significant between the three stages (P〉0.003). CONCLUSIONS: There are four major patterns of HI3-ACLF, including the Heat Toxin Stagnation Pat- tern, the Damp-heat Obstruction Pattern, the Yang Qi Deficiency Pattern, and the Liver and Kidney Yin Deficiency Pattern. The Heat Toxin Stagnation and Yang Qi Deficiency Patterns are the representative patterns in the early and late stages of HB-ACLF. In the middle stage of HB-ACLF, the TCM patterns vary in a complicated manner, with no significant differ- ence among the patterns. Treatment for HB-ACLF should vary with the different representative pat- terns in the early and late stages. 展开更多
关键词 Hepatitis B liver failure Acute Statisticaldistributions Traditional chinese medicine patterns
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石军牡蛎煎灌肠治疗湿热蕴结型慢性肝衰竭合并肝性脑病临床研究
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作者 王劲秋 商斌仪 +2 位作者 陈建杰 郑彦希 陈博武 《中西医结合肝病杂志》 CAS 2024年第4期319-322,共4页
目的:观察石军牡蛎煎灌肠联合西医基础疗法治疗慢性肝衰竭湿热蕴结证合并肝性脑病(HE)的临床疗效。方法:慢性肝衰竭湿热蕴结证合并HE患者74例,用随机数字法分为治疗组(37例)和对照组(37例),两组均给予西医基础治疗,治疗组患者予石军牡... 目的:观察石军牡蛎煎灌肠联合西医基础疗法治疗慢性肝衰竭湿热蕴结证合并肝性脑病(HE)的临床疗效。方法:慢性肝衰竭湿热蕴结证合并HE患者74例,用随机数字法分为治疗组(37例)和对照组(37例),两组均给予西医基础治疗,治疗组患者予石军牡蛎煎灌肠,对照组患者予乳果糖溶液灌肠,治疗周期均为4周。4周后评价HE临床有效率、实验室指标、中医证候评分。结果:①治疗4周后,治疗组患者HE临床有效率为86.5%,对照组患者HE临床有效率为72.9%,差异有统计学意义(P<0.05)。②治疗4周后,治疗组患者TBil、ALT、AST、Alb、血氨较治疗前改善(P<0.05),对照组患者ALT、AST、血氨较治疗前改善(P<0.05),治疗组患者改善TBil、ALT、AST、Alb、血氨疗效优于对照组(P<0.05)。③治疗4周后,治疗组患者与对照组患者的PT、PTA较治疗前改善(P<0.05)。④治疗4周后,治疗组患者与对照组患者的中医证候侯评分较治疗前均降低(P<0.05),治疗组患者疗效优于对照组(P<0.05)。结论:石军牡蛎煎灌肠联合西医基础疗法治疗慢性肝衰竭湿热蕴结证合并HE能够提高HE临床疗效,改善肝功能及中医证候,疗效优于乳果糖溶液灌肠。 展开更多
关键词 石军牡蛎煎 中药灌肠 慢性肝衰竭 肝性脑病 乳果糖 湿热蕴结证
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急性肝功能衰竭的猪动物模型 被引量:5
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作者 陈影波 何永源 +3 位作者 杜原赞 邬艳红 杨振帆 范上达 《暨南大学学报(自然科学与医学版)》 CAS CSCD 2000年第6期22-25,共4页
目的 :建立一个比较接近人类条件的急性肝衰竭模型 ,用于人工肝脏治疗的疗效和安全性的测试。方法 :以右旋半乳糖胺来制造猪肝衰竭的大型动物模型 ,分 3组给药 ,剂量分别为0 5、1和 0 75g/kg。观察其临床表现、生理生化指标和病理改... 目的 :建立一个比较接近人类条件的急性肝衰竭模型 ,用于人工肝脏治疗的疗效和安全性的测试。方法 :以右旋半乳糖胺来制造猪肝衰竭的大型动物模型 ,分 3组给药 ,剂量分别为0 5、1和 0 75g/kg。观察其临床表现、生理生化指标和病理改变。结果 :3组实验都能引出与人的临床和生化指标变化相近的肝功能衰竭的表现 ,以 0 75g/kg组最为理想。结论 :以 0 75g/kg的半乳糖胺制造的急性肝功能衰竭的猪动物模型 ,符合人工肝脏研究对动物模型的要求。 展开更多
关键词 肝功能衰竭 动物模型 人工肝脏支持
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非生物人工肝对慢性重型肝炎肝功能支持效果评价 被引量:13
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作者 向德栋 王宇明 +2 位作者 毛青 张绪清 马巧玉 《传染病信息》 2008年第2期90-91,共2页
目的评价非生物人工肝支持治疗对慢性重型肝炎患者肝功能的支持效果及安全性。方法253例早、中、晚期慢性重型肝炎患者在综合治疗基础上给予非生物人工肝支持治疗,观察非生物人工肝支持治疗前后患者肝功能、肾功能、凝血酶原活动度(PTA... 目的评价非生物人工肝支持治疗对慢性重型肝炎患者肝功能的支持效果及安全性。方法253例早、中、晚期慢性重型肝炎患者在综合治疗基础上给予非生物人工肝支持治疗,观察非生物人工肝支持治疗前后患者肝功能、肾功能、凝血酶原活动度(PTA)、血常规及临床症状变化情况。结果253例慢性重型肝炎患者进行非生物人工肝支持治疗后,血清总胆红素(TBIL)及谷丙转氨酶(ALT)下降,PTA上升(P<0.01);临床症状明显改善率为9.1%,有效率47.8%,总有效率为56.9%,不良反应轻。治疗后中、晚期慢性重型肝炎的存活率分别为53.1%、10.4%,早期患者存活9例。结论非生物人工肝支持治疗慢性重型肝炎患者不良反应轻,对肝功能有肯定的支持作用,尤其对早、中期患者支持效果更好。 展开更多
关键词 慢性重型肝炎 肝衰竭 人工肝 肝支持
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中医辨证施治乙型肝炎病毒-慢加急性肝衰竭的思考 被引量:10
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作者 郭丽颖 王静 +5 位作者 李秋伟 苗静 翁奉武 尹美君 徐懂 贾建伟 《中国中西医结合急救杂志》 CAS CSCD 北大核心 2020年第1期101-105,共5页
目的分析乙型肝炎病毒-慢加急性肝衰竭(HBV-ACLF)的中医证候规律,探讨中医证候实质和中西医结合治疗HBV-ACLF的方案.方法回顾性分析天津市第二人民医院收治的64例HBV-ACLF患者的病例资料,收集入院时患者的中医证候信息,包括症状评分和... 目的分析乙型肝炎病毒-慢加急性肝衰竭(HBV-ACLF)的中医证候规律,探讨中医证候实质和中西医结合治疗HBV-ACLF的方案.方法回顾性分析天津市第二人民医院收治的64例HBV-ACLF患者的病例资料,收集入院时患者的中医证候信息,包括症状评分和舌脉积分,采用聚类分析归纳疾病证候特点,评价不同证型的疗效,比较各证型间丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBIL)、白蛋白(ALB)、胆碱酯酶(ChE)、凝血酶原时间(PT)、总胆汁酸(TBA)、凝血酶原活动度(PTA)、纤维蛋白原(FIB)、甲胎蛋白(AFP)等反映肝脏损伤、合成及再生能力指标的差异,分析HBV-ACLF各中医证型的实质.结果64例HBV-ACLF患者的证候、舌质、舌苔、脉象等47项指标信息主要聚类为热毒炽盛证、肝脾血瘀证、肝肾阴虚证、肝郁脾虚证、湿热蕴结证5个证型,所占比例分别为10.94%、10.94%、12.50%、23.43%、42.19%.HBV-ACLF早期患者多为肝郁脾虚证(10例)和湿热蕴结证(12例);HBV-ACLF中期患者中,热毒炽盛证(5例比0例)和肝肾阴虚证(3例比1例)患者较早期患者增多;HBV-ACLF晚期患者中,肝肾阴虚证(4例比3例、1例)和肝脾血瘀证(5例比1例、1例)患者较早期和中期患者增多;各期之间比较差异均有统计学意义(均P<0.05);肝郁脾虚证、湿热蕴结证患者近期疗效明显优于肝脾血瘀证、肝肾阴虚证和热毒炽盛证(治愈为6例、4例比0例、0例、1例,显效为3例、8例比1例、1例、0例,有效为2例、5例比2例、2例、0例,均P<0.05).TBIL、TBA在热毒炽盛证患者中表达最高〔TBIL:(295.09±75.30)μmol/L,TBA:(253.66±44.70)U/L,均P>0.05〕,其次依次为肝郁脾虚证、湿热蕴结证、肝肾阴虚证、肝脾血瘀证,但各证型之间比较差异均无统计学意义;ALT、AST在热毒炽盛证患者中表达最高,在肝脾血瘀证患者中的表达最低;2个证型间的AST比较差异有统计学意义〔U/L:301.20(105.80,638.60)比73.7(65.90,123.30),P<0.05〕.肝脏合成能力方面,肝肾阴虚证患者的凝血相关指标最差,湿热蕴结证最佳,且湿热蕴结证、热毒炽盛证、肝郁脾虚证、肝脾血瘀证、肝肾阴虚证患者的FIB表达比较差异均有统计学意义〔分别为(1.37±0.48)、(1.23±0.51)、(1.28±0.49)、(1.21±0.36)、(0.70±0.42)g/L,均P<0.05〕;肝郁脾虚证和湿热蕴结证患者的ALB、ChE均较高,而肝脾血瘀证和肝肾阴虚证患者的ALB均明显低于湿热蕴结证患者(g/L:25.71±3.52、27.55±3.08比30.88±4.73,均P<0.05).肝脏再生能力方面,湿热蕴结证患者的AFP最高,其次为肝郁脾虚证,肝脾血瘀证最低〔分别为65.64(28.81,171.10)、39.76(10.10,341.00)、4.65(2.27,10.65)ng/L,均P<0.05〕.结论肝郁脾虚证、湿热蕴结证、热毒炽盛证、肝肾阴虚证、肝脾血瘀证为HBV-ACLF的主要证型,能够反映疾病不同阶段肝脏损伤、合成能力及再生能力方面情况.肝郁脾虚证、湿热蕴结证多处于疾病早期,此阶段时可能中西医结合治疗能取得好的疗效;热毒炽盛证最易发生并发症,需联合生物人工肝治疗控制病情;肝脾血瘀证、肝肾阴虚证多处于疾病晚期,建议尽早考虑肝移植. 展开更多
关键词 乙型肝炎病毒-慢加急性肝衰竭 中医证候 证型 中西医结合治疗
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混合型人工肝治疗肝衰竭疗效观察 被引量:2
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作者 何念海 王英杰 +4 位作者 王泽文 刘俊 刘国栋 李嘉佳 王宇明 《第三军医大学学报》 CAS CSCD 北大核心 2003年第6期481-483,共3页
目的 评价混合型人工肝支持方法———血浆置换 +血液灌流吸附治疗肝衰竭的临床疗效、安全性及其对血浆内毒素的清除作用。方法  3 4例肝衰竭患者进行血浆置换 +血液灌流吸附治疗 ,比较治疗前后肝肾功、血常规、PT、血浆内毒素水平的... 目的 评价混合型人工肝支持方法———血浆置换 +血液灌流吸附治疗肝衰竭的临床疗效、安全性及其对血浆内毒素的清除作用。方法  3 4例肝衰竭患者进行血浆置换 +血液灌流吸附治疗 ,比较治疗前后肝肾功、血常规、PT、血浆内毒素水平的变化 ,观察治疗后患者临床症状体征情况等变化。结果 血浆置换 +血液灌流吸附治疗后 ,患者的临床症状均有不同程度改善 ,总有效率为 67.6% ,最终存活率仅为 2 9.1%。检测指标中转氨酶、总胆红素、凝血酶原时间、凝血酶原活动度、内毒素水平较治疗前后差异有显著性意义 (P <0 .0 1,P <0 .0 5 ) ,不良反应较轻。结论 混合型人工肝对肝衰竭有肯定的疗效 。 展开更多
关键词 肝衰竭 人工肝 肝支持
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人工肝支持系统联合中药治疗慢性重型肝炎临床研究 被引量:5
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作者 李芹 林恢 +3 位作者 刘政芳 陈丽芳 潘晨 张娟娟 《中西医结合肝病杂志》 CAS 2010年第1期12-14,共3页
目的:研究人工肝联合中药方重肝合剂治疗慢性重型肝炎(CSH)的疗效。方法:将90例早、中期CSH患者随机分为试验组与对照组,每组45例。对照组给予内科综合治疗及血浆置换,治疗组在对照组的基础上加用重肝合剂,比较两组患者在治疗第6周末的... 目的:研究人工肝联合中药方重肝合剂治疗慢性重型肝炎(CSH)的疗效。方法:将90例早、中期CSH患者随机分为试验组与对照组,每组45例。对照组给予内科综合治疗及血浆置换,治疗组在对照组的基础上加用重肝合剂,比较两组患者在治疗第6周末的主要临床症状改善情况、肝功能、凝血功能、并发症的发生率、血浆置换次数及其疗效等情况。结果:治疗组症状改善优于对照组(P<0.05)。治疗组总有效率为82.22%;对照组总有效率为62.22%,两组总有效率比较差异有显著性意义(P<0.05)。两组患者总胆红素(TBil)水平均明显降低,与治疗前比较均有显著性意义(P<0.05)。治疗组进行血浆置换(3.1±1.5)次,对照组(5.8±1.6)次,两组比较差异有显著性意义(P<0.05)。结论:人工肝联合中药方重肝合剂治疗早、中期慢性重型肝炎可改善患者临床症状,促进胆红素的代谢,减少并发症的发生率,减少人工肝治疗次数,改善患者预后。 展开更多
关键词 肝炎 慢性重型 中药 人工肝支持系统 临床研究
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非生物型人工肝对肝衰竭患者疗效和预后的影响 被引量:5
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作者 徐秋仙 张振纲 +4 位作者 吴亮 聂华 章莉莎 黄元成 田德英 《临床内科杂志》 CAS 2015年第7期465-468,共4页
目的探讨非生物型人工肝对乙型病毒性肝炎肝衰竭患者疗效和预后的影响。方法对我科收治的308例乙型病毒性肝炎肝衰竭患者进行前瞻性队列研究,按照不同治疗方法分为人工肝(ALSS)组217例和标准药物治疗(SMT)组91例。两组患者以治疗8... 目的探讨非生物型人工肝对乙型病毒性肝炎肝衰竭患者疗效和预后的影响。方法对我科收治的308例乙型病毒性肝炎肝衰竭患者进行前瞻性队列研究,按照不同治疗方法分为人工肝(ALSS)组217例和标准药物治疗(SMT)组91例。两组患者以治疗8周为疗效观察节点,以48周为预后观察终点。记录患者的症状及肝功能、凝血功能等生化指标变化及其生存时间。应用SPSS17.0软件绘制生存曲线,组间生存率的比较采用Log—rank检验。结果ALSS组患者血清ALT、总胆红素(TBil)水平较人工肝治疗前分别平均下降63.6U/L和34.17μmol/L,凝血酶原活动度(PTA)平均升高7.71%(P〈0.01)。在治疗8周时,ALSS组的临床有效率高于SMT组(52.07%比34.07%,P〈0.01);至12周时,ALss组和SMT组的累积生存率分别为50.4%和42.1%,两者比较差异无统计学意义(p〉0.05);至48周结束时,ALSS组患者的平均生存时间为(186.2±11.5)天,SMT组患者的平均生存时间为(160.3±19.0)天,两组患者1年累积生存率比较差异无统计学意义(44.3%比40.7%,P〉0.05)。结论非生物型人工肝可以改善乙型病毒性肝炎肝衰竭患者的临床疗效,但并不能提高其生存率。 展开更多
关键词 人工肝支持系统 非生物型 肝衰竭 肝炎 乙型 生存率
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基于真实世界研究“补肾生髓成肝”治疗乙型肝炎相关性肝衰竭的临床疗效 被引量:9
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作者 戴玲 高翔 +2 位作者 叶之华 姚欣 李瀚旻 《中西医结合肝病杂志》 CAS 2018年第6期325-327,356,共4页
目的:基于真实世界临床数据,探讨基于补肾生髓成肝的中西医结合治疗方案(简称:补肾生髓成肝治疗方案)治疗乙型肝炎相关性肝衰竭的临床疗效。方法:回顾性收集2012年7月至2018年3月在湖北省中医院住院治疗的乙型肝炎相关性肝衰竭患者的临... 目的:基于真实世界临床数据,探讨基于补肾生髓成肝的中西医结合治疗方案(简称:补肾生髓成肝治疗方案)治疗乙型肝炎相关性肝衰竭的临床疗效。方法:回顾性收集2012年7月至2018年3月在湖北省中医院住院治疗的乙型肝炎相关性肝衰竭患者的临床资料417例。根据患者的治疗方案分为西药治疗组(74例)、中西医结合治疗组(150例)和补肾生髓成肝治疗组(193例),观察3组患者治疗8周后患者死亡率及临床生化指标(ALT、TBil、Alb、PTA)改善情况。结果:治疗8周后补肾生髓成肝治疗组的死亡率(12. 95%)显著低于西药治疗组(48. 65%)和中西医结合治疗组(30. 67%),组间比较差异有统计学意义(P <0. 05);补肾生髓成肝治疗组在降低总胆红素(TBil)及升高血清白蛋白(Alb)方面与西药治疗组和中西医结合治疗组比较差异有统计学意义(P <0. 05)。3组患者ALT均较治疗前显著下降,凝血酶原活动度(PTA)较治疗前升高,但组间比较差异均无统计学意义(P>0. 05)。结论:基于补肾生髓成肝的中西医结合治疗方案治疗乙型肝炎相关性肝衰竭能更好地促进黄疸消退及升高血清白蛋白,降低患者的死亡率。 展开更多
关键词 肝炎 乙型 肝衰竭 补肾生髓成肝 中西医结合治疗
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非生物型人工肝对乙型肝炎肝衰竭干预时机的临床研究 被引量:4
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作者 徐秋仙 张振纲 +2 位作者 聂华 章莉莎 田德英 《中西医结合肝病杂志》 CAS 2015年第3期133-136,140,共5页
目的:分析非生物型人工肝对乙型肝炎肝衰竭患者疗效和预后的影响,探讨其对肝衰竭的干预时机。方法:对2007年1月至2011年12月武汉同济医院感染科的308例乙型肝炎肝衰竭患者进行前瞻性临床观察,接受标准药物+非生物型人工肝治疗的为人工肝... 目的:分析非生物型人工肝对乙型肝炎肝衰竭患者疗效和预后的影响,探讨其对肝衰竭的干预时机。方法:对2007年1月至2011年12月武汉同济医院感染科的308例乙型肝炎肝衰竭患者进行前瞻性临床观察,接受标准药物+非生物型人工肝治疗的为人工肝(ALSS)组,仅接受标准药物治疗的为标准药物治疗(SMT)组;两组分别分为早、中、晚3期。结果:治疗8周时,ALSS组的有效率优于SMT组(52.07%vs 34.07%,P=0.004)。ALSS组与SMT组的12周及48周累积生存率差异均无显著性意义(12周:50.4%vs 42.1%,48周:44.3%vs 40.7%,P均>0.05)。ALSS组早、中、晚3期的12周累积生存率分别为81.8%、62.3%、14.9%,48周累积生存率分别为72.7%、56.7%、9.6%;SMT组早、中、晚3期的12周累积生存率分别为79.4%、42.9%、15.3%,48周累积生存率分别为73.3%、42.9%、12.3%。两组相比,早期、晚期患者的12周及48周累积生存率差异均无显著性意义(P均>0.05),中期患者的12周及48周累积生存率差异均有显著性意义(P均<0.05)。结论:非生物型人工肝不但可以改善肝衰竭患者的临床疗效,而且可以提高中期肝衰竭患者的生存率,但对早期及晚期肝衰竭患者疗效有限。 展开更多
关键词 人工肝支持系统 非生物型 肝衰竭 肝炎 乙型 生存率
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中西医结合治疗乙型肝炎相关肝衰竭临床研究 被引量:6
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作者 周双男 张宁 +7 位作者 王立福 张晓峰 杨慧银 李丰衣 白云峰 刘冰 王仲霞 李筠 《军医进修学院学报》 CAS 2012年第7期697-699,721,共4页
目的观察中西医结合疗法对乙型肝炎相关肝衰竭的临床疗效。方法收集入组乙型肝炎相关慢性肝衰竭(HBV-relatedchronic liver failure,HBV-CLF)患者51例及乙型肝炎相关慢加急性肝衰竭(HBV-related acute on chronic liver failure,HBV-AC... 目的观察中西医结合疗法对乙型肝炎相关肝衰竭的临床疗效。方法收集入组乙型肝炎相关慢性肝衰竭(HBV-relatedchronic liver failure,HBV-CLF)患者51例及乙型肝炎相关慢加急性肝衰竭(HBV-related acute on chronic liver failure,HBV-ACLF)患者52例。HBV-CLF对照组24例,治疗组27例;HBV-ACLF对照组26例,治疗组26例。对照组给予常规保肝、抗病毒、对症支持等治疗,疗程4周。治疗组在对照组相同治疗基础上给予辨证中药治疗。结果 HBV-CLF治疗组临床有效率为63.0%,对照组为54.2%(P>0.05);治疗组凝血酶原活动度(PTA)恢复情况更好,肝性脑病发生率有所降低(P<0.05)。HBV-ACLF治疗组临床有效率为80.8%,对照组为53.8%(P<0.05);治疗组总胆红素(TBil)、PTA、胆碱酯酶(CHE)、白蛋白(ALB)恢复情况更好,腹水、肝性脑病发生率有所降低(P<0.05)。结论中西医结合治疗可提高HBV-ACLF临床疗效;对HBV-CLF未见明显优势,但在部分改善指标及降低并发症方面有一定作用。 展开更多
关键词 中西医结合 乙型肝炎 肝衰竭 疗效
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HBV相关性慢加亚急性肝衰竭中医症候群积分与疾病分期及预后相关性研究 被引量:6
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作者 周意 孙克伟 +3 位作者 阳航 黄裕红 张涛 朱文芳 《中西医结合肝病杂志》 CAS 2015年第1期13-15,共3页
目的:观察HBV相关性慢加亚急性肝衰竭(HBV-ACLF)患者中医症候群积分与病情分期、预后的相关性。方法:以中医证素研究为理论基础,以湿热、脾虚、血瘀症候群各自中医症候量化表为标准,观察124例HBV-ACLF患者3种症候群积分差异与病情分期... 目的:观察HBV相关性慢加亚急性肝衰竭(HBV-ACLF)患者中医症候群积分与病情分期、预后的相关性。方法:以中医证素研究为理论基础,以湿热、脾虚、血瘀症候群各自中医症候量化表为标准,观察124例HBV-ACLF患者3种症候群积分差异与病情分期及预后的关系。结果:与中/晚期肝衰竭患者比较,早期患者湿热症候群积分较高,血瘀症候群积分较低,差异均有统计学意义(P<0.05);血瘀症候群积分为肝衰竭早期患者预后影响因素(OR>1),脾虚症候群积分为肝衰竭中/晚期患者预后影响因素(OR>1)。结论 HBV-ACLF早期以湿热症候群表现为主,中晚期以血瘀、脾虚症候群表现为主;血瘀、脾虚症候群积分为预后影响因素之一。 展开更多
关键词 肝炎病毒 乙型 慢加亚急性肝衰竭 中医 分期 预后
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中药内服、灌肠联合常规疗法治疗早中期乙型肝炎病毒相关慢加急性肝衰竭的临床观察 被引量:8
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作者 汤伯宗 杨宗国 +4 位作者 叶晨 陈姼姼 陆云飞 陈晓蓉 徐庆年 《上海中医药杂志》 2019年第8期60-64,共5页
目的观察利湿解毒方内服、通腑逐瘀方灌肠联合常规疗法治疗乙型肝炎病毒相关慢加急性肝衰竭(HBV-ACLF)的临床疗效。方法将139例HBV-ACLF患者随机分为治疗组(72例)和对照组(67例)。对照组采用内科综合治疗,治疗组在对照组治疗措施的基础... 目的观察利湿解毒方内服、通腑逐瘀方灌肠联合常规疗法治疗乙型肝炎病毒相关慢加急性肝衰竭(HBV-ACLF)的临床疗效。方法将139例HBV-ACLF患者随机分为治疗组(72例)和对照组(67例)。对照组采用内科综合治疗,治疗组在对照组治疗措施的基础上加用利湿解毒方口服、通腑逐瘀方灌肠。两组疗程均为8周,分别于治疗2周、4周、8周及疗程结束12周,观察生存率,比较肝功能[丙氨酸氨基转移酶(ALT)、总胆红素(TBil)、胆碱酯酶(CHE)]、凝血酶原活动度(PTA)、乙肝病毒定量(HBV-DNA)、终末期肝病模型(MELD)评分的变化情况。结果①治疗组总生存率及治疗2周、4周的生存率分别为65.3%、86.1%、95.2%,对照组分别为43.3%、67.2%、80.0%,组间差异有统计学意义(P<0.05)。②治疗前与治疗2周、治疗4周、治疗8周、疗程结束12周组内比较,两组血清ALT、TBil、CHE、PTA水平及MELD评分差异均有统计学意义(P<0.05);治疗4周、治疗8周后组间比较,血清ALT、TBil、CHE、PTA水平及MELD评分差异有统计学意义(P<0.05)。③治疗前与治疗2周、治疗4周、治疗8周、疗程结束12周组内比较,两组HBV-DNA水平降低(P<0.05);治疗8周后组间比较,治疗组HBV-DNA水平低于对照组(P<0.05)。结论利湿解毒方内服、通腑逐瘀方灌肠联合常规疗法治疗HBV-ACLF疗效满意,较常规疗法能更好地改善患者的肝功能、凝血功能,降低HBV-DNA水平,提高HBV-ACLF患者的短期生存率。 展开更多
关键词 慢加急性肝衰竭 乙型肝炎病毒 中西医结合疗法 利湿解毒方 通腑逐瘀方 灌肠 生存率
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中药联合血浆置换治疗慢性重型肝炎临床观察 被引量:6
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作者 林恢 李芹 张娟娟 《传染病信息》 2009年第5期305-307,共3页
目的探讨中药联合血浆置换治疗早、中期慢性重型肝炎的疗效。方法将60例慢性重型肝炎早、中期住院患者随机分成治疗组和对照组,每组30例。对照组给予内科综合治疗及血浆置换,治疗组加用中药,所有患者根据病情决定血浆置换次数。结果治... 目的探讨中药联合血浆置换治疗早、中期慢性重型肝炎的疗效。方法将60例慢性重型肝炎早、中期住院患者随机分成治疗组和对照组,每组30例。对照组给予内科综合治疗及血浆置换,治疗组加用中药,所有患者根据病情决定血浆置换次数。结果治疗组症状改善优于对照组(P<0.001)。治疗组临床治愈8例,好转16例,无效6例,总有效率为80.00%;对照组临床治愈7例,好转15例,无效8例,总有效率为73.33%。2组总有效率比较差异无统计学意义(P>0.05)。治疗组进行血浆置换(3.0±1.3)次,对照组进行(5.2±1.9)次,2组比较差异有统计学意义(P<0.01)。结论中药联合血浆置换治疗早、中期慢性重型肝炎可明显改善症状,减少血浆置换的次数,取得较好疗效。 展开更多
关键词 慢性重型肝炎 中药 人工肝支持系统 血浆置换
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