白蛋白在药物性肝衰竭患者血浆置换治疗中的应用价值  

Application Value of Albumin in Plasma Exchange Treatment of Patients with Drug-induced Liver Failure

作　　者：陈琼[1] 周朝阳[1] 席明霞 成晶 CHEN Qiong;ZHOU Chao-Yang;XI Ming-Xia;CHENG Jing(Changsha Central Hospital Affiliated to University of South China,Changsha 410004,China)

机构地区：[1]长沙市中心医院,长沙410004

出　　处：《中国药物经济学》2021年第4期34-37,共4页China Journal of Pharmaceutical Economics

基　　金：湖南省卫生健康委2020年度科研立项课题(湘卫函[2019]569号)。

摘　　要：目的探讨白蛋白用于药物性肝衰竭患者血浆置换治疗的临床疗效。方法选取2019年5月至2020年7月长沙市某三甲综合医院重症医学科收治的40例抗结核药物性肝衰竭患者作为研究对象,按照治疗先后顺序分组,前20例为对照组,后20例为观察组。观察组选用5%白蛋白注射液代替部分置换液联合血浆进行血浆置换治疗,对照组选用新鲜冰冻血浆为单一置换液进行血浆置换治疗。比较两组患者血浆置换前后肝功能、凝血指标变化及不良反应发生情况。结果治疗后,两组患者总胆红素(TBil)、丙氨酸转氨酶(ALT)、血氨(NH_(3))低于治疗前,凝血酶原活动度(PTA)高于治疗前,差异有统计学意义(P<0.05),但组间比较差异无统计学意义(P>0.05);观察组患者治疗后过敏变态反应及低钙血症发生率明显低于对照组,差异有统计学意义(P<0.05)。结论使用白蛋白替代部分置换液行血浆置换,其治疗效果与单一冰冻血浆行血浆置换无差异,但能减少血浆使用,缓解当前用血紧张的局面,并能降低变态反应、低钙血症等并发症的发生,提高患者满意度。Objective To investigate the clinical effect of albumin in plasma exchange treatment in patients with drug-induced liver failure. Methods A total of 40 patients with drug-induced liver failure admitted to the ICU of Changsha Central Hospital were selected as the research objects. According to the order of treatment, the first 20 cases were the control group, and the last 20 cases were the observation group. The observation group chose 5% albumin injection instead of partial replacement fluid combined with plasma for plasma exchange treatment, and the control group chose fresh frozen plasma as a single replacement fluid for plasma exchange treatment. The changes of liver function, coagulation indexes and the occurrence of complications between the 2 groups of patients before and after plasma exchange were compared. Results After treatment, the total bilirubin(TBil), alanine aminotransferase(ALT), and blood ammonia(NH_(3)) of the 2 groups were lower than before treatment, and the prothrombin activity(PTA) was higher than before treatment. The difference was statistically significant(P<0.05), but there were no significant between-group difference(P>0.05);the incidence of allergic allergies and hypocalcemia in the observation group after treatment was significantly lower than that in the control group, and the difference was statistically significant(P<0.05). Conclusion Plasma exchange using albumin instead of partial replacement fluid has the same therapeutic effect as plasma exchange with single frozen plasma, but it can reduce the use of plasma, alleviate the current blood tension, and reduce allergic reaction, hypocalcemia and other complications, improve patient satisfaction.

关 键 词：白蛋白 血浆置换 药物性肝衰竭 

分 类 号：R575.3[医药卫生—消化系统] R977.8[医药卫生—内科学]