HB-H-6树脂吸附胆红素血浆灌流治疗慢性肝病重度黄疸适用范围  

Clinical scope analysis of plasma perfusion using HB-H-6 resin in patients with chronic liver disease and severe jaundice

作　　者：向慧玲[1] 韩涛[1] 杜智[1] 李涛[1] 李隽[1] 吕洪敏[1] 李庭红[1] 周佳美[1] 唐飞[1] 

机构地区：[1]天津市第三中心医院肝胆病院天津市人工细胞重点实验室,天津300170

出　　处：《生物医学工程与临床》2011年第5期456-460,共5页Biomedical Engineering and Clinical Medicine

摘　　要：目的进一步评价HB-H-6树脂吸附胆红素血浆灌流在治疗慢性肝病重度黄疸中的价值及最佳适用范围。方法选择2006年10月～2010年7月天津市第三中心医院94例不同病因慢性肝病重度黄疸患者,其中男性68例,女性26例;年龄29～76岁,中位年龄57岁。接受HB-H-6树脂吸附胆红素血浆灌流治疗,比较单次HB-H-6树脂吸附胆红素血浆灌流治疗前后血清胆红素变化;并探讨不同初始胆红素水平及初始凝血酶原活动度(PTA)水平对HB-H-6树脂吸附胆红素能力的影响。结果单次HB-H-6树脂吸附胆红素血浆灌流治疗前血清总胆红素(TBiL)、直接胆红素(DBiL)、间接胆红素(IBiL)分别为(387.80±183.08)、(238.66±103.52)、(127.23±62.00)μmol/L;治疗后分别为(291.80±135.58)、(183.10±76.29)、(92.85±54.25)μmol/L,血浆灌流治疗能显著降低治疗后血清TBiL、DBiL及IBiL的水平(P<0.01);单次HB-H-6树脂吸附胆红素血浆灌流治疗对TBiL、DBiL及IBiL的清除率分别为23.68%±9.14%、21.54%±9.90%及27.09%±16.84%,HB-H-6树脂对IBiL的吸附能力略强于TBiL及DBiL(P<0.01)。HB-H-6树脂吸附胆红素血浆灌流对不同层次的初始TBiL水平均有效,均能引起治疗后胆红素水平的显著降低(P<0.01);初始TBiL水平越高,HB-H-6树脂清除胆红素的绝对值越高(P<0.01);对初始TBiL水平在200μmol/L以上HB-H-6树脂吸附能力明显高于初始TBiL水平在200μmol/L以下时(P<0.01)。HB-H-6树脂吸附胆红素的能力不受初始PTA影响;无明显不良反应。结论 HB-H-6树脂吸附胆红素血浆灌流作为黄疸的人工肝治疗方法之一,安全有效,且适用于TBiL浓度200μmol/L以上的重度黄疸患者。Objective To extend the value and scope of plasma perfusion using HB-H-6 resin in patients with chronic liver disease and severe jaundice.Methods From October 2006 to July 2010,a total of 94 different causes of chronic liver diseases with severe jaundice were enrolled,male 68,female 26,aged 29-76 years old,median age 57 years old.The blood bilirubin level both before and after treatment were tested and analyzed,and the optimal initial bilirubin ranges and prothrombin time activity（PTA） for HB-H-6 resin therapy were further explored and adverse reactions were recorded.Results The values of total bilirubin（TBiL）,direct bilirubin（DBiL） and indirect bilirubin（IBiL） were（387.80 ± 183.08） μmol/L,（238.66 ± 103.52） μmol/L,（127.23 ± 62.00） μmol/L before treatment,and（291.80 ± 135.58） μmol/L,（183.10 ± 76.29） μmol/L,（92.85 ± 54.25） μmol/L after HB-H-6 resin plasma perfusion treatment respectively.The values of TBiL,DBiL and IBiL were decreased significantly after every single therapy（P 〈 0.01）;The level of TBiL,DBiL and IBiL eliminated by HB-H-6 resin were 23.68 % ± 9.14 %,21.54 % ± 9.90 %,27.09 % ± 16.84 % respectively;the absorptive ability for IBiL was a little higher than that for TBiL and DBiL（P 〈 0.01）.Plasma perfusion with HB-H-6 could effectively decrease different levels of initial TBiL（P 〈 0.01）,the higher the initial bilirubin level,the stronger the absolute value（P 〈 0.01）.The TBiL elimination ability was significantly higher when serum TBiL was more than 200 μmol/L before HB-H-6 resin plasma perfusion therapy,compared with that less than 200 μmol/L（P 〈 0.01） and the absorptive ability did not changed with original PTA level.Conclusion It is demonstrated that HB-H-6 resin could be used as an artificial liver effectively and safely in chronic liver disease with severe jaundice as well as in the patients whose value of TBiL are more than 200 μmol/L.

关 键 词：HB-H-6树脂 胆红素吸附 血液灌流 慢性肝病 黄疸 

分 类 号：R575[医药卫生—消化系统]