血浆置换治疗乙肝相关性肝衰竭的疗效分析  

Analysis of efficacy of plasma exchange in treatment of HBV induced liver failure

作　　者：杨黎冰 仝静[1] 祖晓满 王春峰[1] 

机构地区：[1]郑州大学第一附属医院消化内二科,河南郑州450052

出　　处：《临床消化病杂志》2017年第6期342-345,共4页Chinese Journal of Clinical Gastroenterology

基　　金：河南省基础与前沿技术研究计划项目(No:142300410036);河南省医学科技攻关计划项目(No:201402009)

摘　　要：[目的]探讨血浆置换治疗乙肝相关性肝衰竭的临床疗效。[方法]选取乙肝相关性肝衰竭患者81例,随机分为2组,治疗组(37例)在内科综合治疗的基础上给予人工肝血浆置换,对照组(44例)仅给予内科综合治疗,治疗前后24h检测其血常规、电解质、肝功能、肾功能、凝血功能等化验指标,对比治疗前后患者症状及实验室检查结果的变化。[结果]治疗组患者治疗后临床症状有明显好转,治疗后24h谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBiL)、国际标准化比率(INR)均降低;凝血酶原时间活动度(PTA)升高。治疗组患者行血浆置换治疗共96例次,其中10例次出现不良反应,予以对症治疗后缓解均完成治疗。12周后评定治疗效果,治疗组总有效率为54.1%(20/37),对照组总有效率为31.8%(14/44)。[结论]血浆置换是早期及中期慢加急性乙肝肝衰竭患者安全而有效的治疗手段。[Objective]To evaluate efficacy of plasma exchange in treatment of HBV induced liver failure patients. [Methods]Total 81 cases with HBV induced liver failure from January 2015 to December 2016 in the first affiliated hospital of Zhengzhou university were observed. The patients were randomly divided into two groups：the treatment group which was given the plasma exchange on the basis of the medicine comprehensive treatment, the control group was only given medicine comprehensive treatment. Patients＇ clinical symptoms, blood routine examination, electrolyte, hepatic and renal function data, coagulation function data were recorded before and 24 h after plasma exchange, [Results]After the plasma exchange, the clinical symptoms of the treatment group were improved obviously. The levels of ALT,AST,TBiL and INR all decreased obviously,the levels of PTA were increased. In treatment group, 37 cases of liver failure patients received a total of 96 plasma exchange treatment,adverse reactions occurred in 10 cases,and were all relieve by the symptomatic treatment and completed all the procedure. The total effective rate in the treatment group 12 weeks after the treatment in treatment group was 54.1% （20/37）,while the total effective rate in control group was 31.8（14/44）. [Conclusion]Plasma exchange is a safe and effective method in patients with early and mild-termacute-on-chronic HBV liver failure.

关 键 词：血浆置换 肝衰竭 疗效 

分 类 号：R512.62[医药卫生—内科学] R575.3[医药卫生—临床医学]