血浆置换联合血浆灌流治疗肝衰竭患者临床疗效分析  

Plasma exchange combined with plasma perfusion in treatment of patients with liver failure

作　　者：范晶华[1] 陈红英[1] 王宏图[1] 段志文[1] 李鲜丽[1] 晁春梅[1] 

机构地区：[1]昆明医科大学第一附属医院感染性疾病科,昆明市650032

出　　处：《实用肝脏病杂志》2016年第2期184-187,共4页Journal of Practical Hepatology

基　　金：云南省教育厅项目(编号:2012Y019);云南省高层次卫生技术人才培养专项经费资助项目(编号:D-201219)

摘　　要：目的探讨血浆置换（PE）联合血浆灌流（PP）治疗肝衰竭患者的临床疗效。方法选择2012年6月～2015年7月我科治疗的肝衰竭患者46例为观察组,行PE联合PP治疗;以2007年1月～2008年5月治疗的肝衰竭患者46例为对照组,行单纯PE治疗。采用日本OLYMPUS AU5400全自动生化分析仪检测肝功能指标;采用酶联免疫吸附法检测CRP、TNF-α、IL-6水平。结果观察组显效率和总有效率（分别为41.3%和93.47%）均明显高于单纯PE组（21.74%和78.26%,P〈0.05）;治疗后,观察组患者血清TBIL、INR、NH3、CRP、TNF-α和IL-6水平分别为（308.3±35.3）μmol/L、（1.6±0.2）、（214.3±22.7）μmol/L、（7.4±1.1）mg/L、（1128.3±345.3）ng/L和（115.5±12.0）ng/L,明显低于对照组【分别为（326.1±38.4）μmol/L、（1.9±0.8）、（267.5±26.1）μmol/L、（10.3±1.3）mg/L、（2012.3±318.4）ng/L和（184.3±20.1）ng/L,P〈0.05】;观察组ALB水平为（34.3±4.9）g/L,明显高于对照组【（31.4±3.9）g/L,P〈0.05】;观察组并发症发生率为19.6%,显著低于对照组的36.1%（P〈0.05）。结论血浆置换联合血浆灌流治疗肝衰竭患者有助于清除炎性因子,改善肝功能,提高治疗效果。Objective To study the effects of plasma exchange（PE） combined with plasma perfusion（PP） to treat patients with liver failure. Methods 46 patients with liver failure from June 2012 to July 2015 were selected as observation group,and the patients were treated by using PE combined with PP,and another 46 patients with liver failure from January 2007 to May 2008 were selected as control group,and they were treated by using PE alone. Total serum bilirubin（TBIL）,albumin（ALB）,thrombin original time international normalized ratio（INR）,ammonia（NH3） were detected routinely,and serum C-reactive protein（CRP）,tumor necrosis factor-α（TNF-α）,interleukin-6（IL-6） were detected by ELISA. Results The effective rates and total effective rates（41.3%,93.47%） in the observation group were significantly higher than in control group（21.74%,78.26%,P〈0.05）;Serum TBIL,INR,NH3,CRP,TNF-α and IL-6 levels in the observation group was（308.3±35.3） μmol/L,（1.6±0.2）,（214.3±22.7） μmol/L,（7.4±1.1） mg/L,（1128.3±345.3） ng/L and（115.5±12.0） ng/L,significantly lower than in the control group [（326.1 ±38.4） μmol/L,（1.9 ±0.8）,（267.5 ±26.1） μmol/L,（10.3 ±1.3） mg/L,（2012.3 ±318.4） ng/L,（184.3±20.1） ng/L,P〈0.05];Serum ALB level in the observation group was（34.3±4.9）g/L,significantly higher than in the control group [（31.4±3.9）g/L,P〈0.05];The incidence of complications in the observation group was 19.6%, significantly lower than in the control group（36.1%,P〈0.05）. Conclusions Plasma exchange and plasma perfusion are helpful to clear inflammatory cytokines,and improve liver function in patients with liver failure.

关 键 词：肝衰竭 血浆置换 血浆灌流 炎性因子 

分 类 号：R575.3[医药卫生—消化系统]