人工肝血浆置换联合胆红素吸附治疗对重症肝炎患者炎症因子的影响  

Effect of artificial liver plasma exchange combined with bilirubin adsorption therapy on inflammatory cytokines of patients with serious hepatitis

作　　者：张泽敏 黄仕艺 于兰芳 李一鸣 

机构地区：[1]六盘水市水城矿业控股集团总医院感染科,贵州六盘水553000

出　　处：《中华医院感染学杂志》2014年第8期1830-1831,1834,共3页Chinese Journal of Nosocomiology

基　　金：贵州省科学技术基金项目(黔科合字20122305)

摘　　要：目的探讨人工肝血浆置换联合胆红素吸附治疗对重症肝炎患者炎症因子水平的影响。方法收集2011年8月-2013年9月对符合重症肝炎诊断标准的70例患者实施人工肝血浆置换联合胆红素吸附治疗;实施治疗前、后采用ELISA法检测患者血液炎症因子水平变化,采用SPSS18.0软件进行统计分析。结果治疗存活率为68.6℅;治疗结束时肿瘤坏死因子(TNFα)水平为(39.53±17.43)pg/ml,白介素-6(IL-6)水平为(34.37±13.65)pg/ml,干扰素(IFNγ)水平为(40.79±12.51)pg/ml,均较治疗前明显下降;IL-12水平为(300.64±173.82)pg/ml,较治疗前明显升高,差异有统计学意义(P<0.05);治疗结束4d患者TNFα水平为(68.73±23.54)pg/ml,IL-6水平为(62.79±13.62)pg/ml、IL-10水平为(34.23±17.72)pg/ml、IL-12水平为(126.69±47.59)pg/ml、IFNγ水平为(49.52±17.56)pg/ml,较治疗前差异均无统计学意义。结论人工肝血浆置换联合胆红素吸附疗法能有效清除患者体内有害炎性介质,同时促进有益炎症细胞因子的产生。OBJECTIVE To study the effect of plasma exchange（PE）combined with bilirubin adsorption （BA） thera- py on the inflammatory cytokines of patients with severe hepatitis. METHODS Selected 70 patients who met the diagnostic criteria for severe hepatitis and were hospitalized during Aug 2011--2013; the PE-BA therapy was con- ducted for those patients. The change trend of inflammatory cytokines in patients blood detected with ELISA before and after treatment, and made a statistical analysis with SPSS 18.0 software. RESULTS Survival rate after treatment was 68.6%. After treatment, the level of TNF, IL-6 and IFN was （39. 53± 17. 43）pg/ml, （34. 37 ± 13.65）pg/ml, （40.79±12.51） pg/ml respectively, which showed a significant decrease, while the level of IL-12 was （300.64±173.82）pg/ml, which was significantly higher than before treatment （P〈0.05）. After treat- ment, the level of TNF , IL-6, IL-10, IL-12 and IFN was （68.73±23.54）pg/mi, （62.79±13.62）pg/ml, （34.23± 17.72）pg/ml, （126.69±47.59）pg/ml, （49.52±17.56）pg/ml respectively ; the difference had no statistical sig- nificance compared with the results before treatment. CONCLUSION The PE therapy combining with BA can effectively remove harmful inflammatory mediators in the bodies of patients and promote the production of benefi- cial inflammatory cytokines.

关 键 词：血浆置换 胆红素吸附 重症肝炎 炎症因子 

分 类 号：R512.6[医药卫生—内科学]