根据PTA预测血浆置换治疗重型肝炎高胆红素血症的疗效  

Assessment on curative effect of plasma exchange for treating chronic severe hepatitis with hyperbilirubinemia based on prothrombin activity

作　　者：刘振国[1] 万克青[1] 龚环宇[1] 张文坚[1] 龚健[1] 戴婵媛[1] 

机构地区：[1]中南大学湘雅三医院,湖南长沙410013

出　　处：《中国感染控制杂志》2006年第2期117-119,123,共4页Chinese Journal of Infection Control

摘　　要：目的探讨根据凝血酶原活动度(PTA)预测重型肝炎高胆红素血症行血浆置换的临床疗效。方法选取重型肝炎高胆红素血症患者80例(均给予内科综合治疗),分成4组:A1与A2组,均PTA≤20%,A1组9例,共行血浆置换16次,A2组17例(未行血浆置换)设为对照组;B1与B2组为20%<PTA≤40%,B1组24例,共行血浆置换53次,B2组30例(未行血浆置换)设为对照组。比较4组患者治疗效果。结果经治疗后,A1与A2组患者症状和血清学指标改善均不明显,A1组好转率为11.11%,A2组好转率为11.76%,两组好转率差异无显著性(P>0.05);而B1组患者症状和血清学指标改善均优于B2组,且其好转率87.50%明显高于B2组好转率63.33%(P<0.05)。结论血浆置换对PTA>20%的早、中期重型肝炎高胆红素血症治疗效果较好。Objective To evaluate the treatment of plasma exchange （PE） in patients with chronic severe hepatitis based on prothrombin activity （PTA）. Methods Eighty patients of chronic severe hepatitis with hyperbilirubinemia were included in this study. Based on PTA, patients were divided into four groups. Group A1 and A2 were PTA 420%, 9 patients of A1 received 16 times of treatment with PE, and 17 patients of A2 without PR served as controls. B1 and B2 were 20% 〈 PTA≤40%, 24 patients of B1 received 53 times of treatment with PE, and 30 patients of 132 served as controls. Results The serologic marks and symptoms were not significantly different between A1 and A2, the rate of improvement of A1 was 11.11%, A2 was 11.76% （ P 〉0.05）. There was significant difference between B1 and B2, the rate of improvement of B1 was 87.50%, and B2 was 63.33% （ P 〈 0.05）. Conclusion If PTA is more than 20%, PE is an efficient treatment for early and middle term of chronic severe hepatitis with hyperbilirubinemia.

关 键 词：血浆置换 高胆红素血症 凝血酶原活动度 治疗应用 

分 类 号：R512.6[医药卫生—内科学]