血浆置换术联合双重血浆分子吸附系统在重型乙型肝炎中的疗效观察  

Observation of curative effect of plasma exchange combined with dual plasma molecular adsorption system in severe hepatitis B

作　　者：李冬梅 罗强 刘海波 LI Dongmei;LUO Qiang;LIU Haibo(Department of Clinical Laboratory,People′s Hospital of Qijiang District,Chongqing 401420,China)

机构地区：[1]重庆市綦江区人民医院检验科,重庆401420

出　　处：《检验医学与临床》2022年第6期762-765,共4页Laboratory Medicine and Clinic

摘　　要：目的探讨血浆置换术(PE)联合双重血浆分子吸附系统(DPMAS)治疗重型乙型肝炎(SHB)的近期疗效,以及SHB患者总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)水平变化情况。方法选取2017年1月至2018年12月在该院治疗的112例SHB患者作为研究对象,分为联合治疗组(采用PE联合DPMAS治疗)和对照组(采用PE治疗),每组各56例。观察PE联合DPMAS治疗SHB的疗效,同时观察两组患者血清TBIL、ALT、肌酐(Cr)、K^(+)、Cl^(-)水平的变化情况及终末期肝病模型(MELD)评分情况。结果两组患者治疗前Cr、K^(+)、Cl^(-)水平比较,差异均无统计学意义(P>0.05),联合治疗组患者治疗结束24 h后Cr、K^(+)、Cl^(-)水平均明显优于对照组,差异均有统计学意义(P<0.05);联合治疗组患者治疗结束24 h后血清TBIL、ALT水平均低于对照组,差异均有统计学意义(P<0.05);联合治疗组患者治疗结束24 h后MELD评分中位数从27分下降至22分,对照组患者MELD评分也有所下降,但明显高于联合治疗组,差异均有统计学意义(P<0.05);联合治疗组患者有效率为82.14%,对照组患者有效率为75.00%,两组患者有效率比较,差异无统计学意义(P>0.05);联合治疗组患者有3例出现头晕、恶心,对照组患者有2例出现头晕、恶心,两组患者治疗后不良反应发生率比较,差异无统计学意义(P>0.05)。结论PE联合DPMAS可有效治疗SHB,同时可改善患者血清Cr、K^(+)、CL^(-)及TBIL、ALT水平,值得临床推广应用。Objective To investigate the short-term efficacy of plasma exchange(PE)combined with dual plasma molecular adsorption system(DPMAS)in the treatment of severe hepatitis B(SHB)and the changes of total bilirubin(TBIL)and alanine aminotransferase(ALT)levels in SHB patients.Methods A total of 112 SHB patients who were treated in this hospital from January 2017 to December 2018 were selected as the research objects,and divided into a combined treatment group(used PE combined with DPMAS therapy)and a control group(treated with PE),with 56 cases in each group.Observed the curative effect of PE combined with DPMAS in the treatment of SHB,and observed the changes of serum TBIL,ALT,creatinine(Cr),K^(+),Cl^(-)levels and the model of end-stage liver disease(MELD)score in the two groups.Results There was no significant difference in the levels of Cr,K^(+)and Cl^(-)between the two groups before treatment(P>0.05).The levels of Cr,K^(+)and Cl^(-)in the combined treatment group were significantly better than those in the control group after 24 h of treatment,the differences were statistically significant(P<0.05).The serum TBIL and ALT levels in the combined treatment group were lower than those in the control group after 24 h of treatment,and the differences were statistically significant(P<0.05).After 24 h of treatment,the median MELD score in the combined treatment group decreased from 27 to 22,and the MELD score in the control group also decreased,but it was significantly higher than that in the combined treatment group,and the differences were statistically significant(P<0.05).The effective rate of the combined treatment group was 82.14%,and the effective rate of the control group was 75.00%.There was no significant difference in the effective rate between the two groups(P>0.05).There were 3 cases of dizziness and nausea in the combined treatment group,and 2 cases of dizziness and nausea in the control group,there was no significant difference in the incidence of adverse reactions between the two groups after treatment(P>0.05)

关 键 词：血浆置换术 双重血浆分子吸附系统 重型乙型肝炎 总胆红素 丙氨酸氨基转移酶 

分 类 号：R575.1[医药卫生—消化系统]