混合型生物人工肝治疗急性肝衰竭动物的实验研究  

Experimental study of hybrid bioartificial liver therapy for animal model with acute hepatic failure

作　　者：王凯[1] 赵显国[1] 段钟平[2] 王欣芳[1] 李素珍[1] 

机构地区：[1]郑州大学第一附属医院血液净化中心河南省高等学校临床医学重点学科开放实验室,郑州450052 [2]首都医科大学附属北京佑安医院人工肝治疗培训中心,北京100069

出　　处：《中国血液净化》2010年第7期389-392,共4页Chinese Journal of Blood Purification

基　　金：国家科技部科技攻关计划引导项目(2003BA753C);河南省卫生厅医学科技创新人才工程计划项目(20060028)

摘　　要：目的评估混合型生物人工肝对急性肝衰竭动物的治疗效果。方法混合型生物人工肝由血浆置换、血液滤过和猪肝细胞型生物人工肝构成。6只中国实验小型猪采用D-氨基半乳糖静脉注射建立急性肝衰竭动物模型,在给药48h后给予混合型生物人工肝治疗,先进行血浆置换联合血液滤过,再经过猪肝细胞型生物人工肝处理。观察比较实验动物治疗前后的临床表现及各相关指标的变化;并比较血浆置换联合血液滤过后猪肝细胞型生物人工肝处理后血液中相应指标的变化。结果本组实验动物在混合型生物人工肝治疗过程中生命体征平稳,未发生严重不良反应。与治疗前相比,治疗后实验动物血液中总胆红素、氨、丙氨酸转移酶、内毒素、肌酐明显减少(P<0.01),纤维蛋白原、凝血酶原活动度和甲胎蛋白明显增加(P<0.01);与血浆置换联合血液滤过比较,猪肝细胞型生物人工肝治疗后血液中纤维蛋白原、凝血酶原活动度有所增加(P<0.05),血氨、总胆红素明显降低(P<0.01)。结论应用混合型生物人工肝治疗急性肝衰竭安全、有效。混合型生物人工肝较非生物型人工肝(血浆置换+血液滤过)效果好。Objective To evaluate the therapeutic effects of hybrid bioartificial liver （HBL） on animal acute hepatic failure model. Methods HBL consisted of plasma exchange, hemofiltration and porcine hepatocyte-based bioartificial liver. Six experimental minipigs were induced to have acute hepatic failure by administration of Dgalactosamine. After 48 hours the animals were treated with plasma exchange plus hemofiltration then followed by porcine hepatocyte-based bioartificial liver. Clinical manifestations and serum indexes of the animals were observed and compared with those at different treatment stages. Results No significant changes in vital signs were found, and the adverse effects did not occur in these animals during the treatment. Compared with those before HBL treatment, the concentrations of blood total bilirubin, NH3, alanine transferase, endotoxin and creatinine were much lower （P〉0.01）, and levels of fibrinogen, prothrombin activity and alpha-fetoprotein were much higher （P〈0.01） after HBL treatment. Compared with those after plasma exchange plus hemofiltration, serum fibrinogen and prothrombin activity were higher （P〈0.05）, and serum NH3 and total bilirubin were lower after the porcine hepatocyte-based bioartificial liver treatment. Conclusions The treatment of HBL for acute hepatic failure is safe and effective, and is superior to the efficacy of plasma exchange plus hemofiltration.

关 键 词：混合型生物人工肝 血浆置换 血液滤过 急性肝衰竭 

分 类 号：R318.16[医药卫生—生物医学工程]