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肝脏透析的体内量化:白蛋白透析和分次血浆分离的比较
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作者 Krisper P. Haditsch B. +1 位作者 Stauber R. 王志宇 《世界核心医学期刊文摘(胃肠病学分册)》 2006年第1期54-54,共1页
Background/Aims: Artificial liver support represents a potentially useful option for the treatment of severe liver failure. A sufficient ‘ dose’ might be crucial for such treatments to provide a survival benefit. Th... Background/Aims: Artificial liver support represents a potentially useful option for the treatment of severe liver failure. A sufficient ‘ dose’ might be crucial for such treatments to provide a survival benefit. The aim of this study was to compare in vivo efficiency and resulting delivered treatment dose of two commercially available devices that use different therapeutic principles: albumin dialysis (AD, MARS ) and fractionated plasma separation (FPS, Prometheus ). Methods: Eight patients with acute-on-chronic liver failure were treated alternately with AD and FPS. Thirty-two treatments at identical blood and dialysate flow rates were evaluated. Clearance and reduction ratio (a measure of delivered treatment dose)were compared for bilirubin subfractions, ammonia and urea. Results: FPS achieved significantly higher clearance for all measured protein-bound and water-soluble markers. This resulted in significantly higher reduction ratios for FPS compared to AD. Unconjugated bilirubin, a marker for strongly albumin-bound toxins, was influenced only by FPS. Conclusions: FPS provided a higher delivered treatment dose than a matching treatment with AD. Reduction ratios of bilirubin and urea should be reported in clinical studies on liver dialysis, since delivered dose is likely to be linked to the clinical effectiveness of extracorporeal liver support therapies. 展开更多
关键词 血浆分离 肝衰竭患者 慢性肝衰竭 结合性胆红素 治疗原理 人工肝支持 尿素清除率 结合蛋白 临床效应
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