人工肝治疗次数及模式对肝衰竭患者生存时间的影响  

Effects of artificial liver treatment frequency and mode on survival time of patients with liver failure

作　　者：王一帆 杨艳芬 史诗 邓春青[3] WANG Yifan;YANG Yanfen;SHI Shi;DENG Chunqing(Department of Internal Medicine,the First Clinical Medical College of Shanxi Medical University,Taiyuan,Shanxi,030001;School of Public Health of Shanxi Medical University,Taiyuan,Shanxi,030001;Department of Infectious Diseases,the First Hospital of Shanxi Medical University,Taiyuan,Shanxi,030001)

机构地区：[1]山西医科大学第一临床医学院内科,山西太原030001 [2]山西医科大学公共卫生学院,山西太原030001 [3]山西医科大学第一医院感染病科,山西太原030001

出　　处：《实用临床医药杂志》2023年第9期20-24,共5页Journal of Clinical Medicine in Practice

基　　金：“艾滋病和病毒性肝炎等重大传染病防治”科技重大专项“十三五”计划课题(2017ZX10302201);北京肝胆相照公益基金会人工肝专项基金(iGandanF-1082022-RGG005)。

摘　　要：目的探讨人工肝治疗次数及模式对肝衰竭患者预后的影响。方法选取行人工肝治疗的102例肝衰竭患者为研究对象。102例患者分别按人工肝治疗次数分组[行1次人工肝治疗组(16例)、行2~4次人工肝治疗组(69例)、行5次人工肝治疗组(10例)和行≥6次人工肝治疗组(7例)]和人工肝治疗模式分组[血浆置换组(PE组,69例)、双重血浆分子吸附系统组(DPMAS组,2例)和联合组(31例)]。各组间化验指标采用M-W或K-W非参数检验,各组间生存时间比较采用K-M生存分析,并行Log-rank检验。结果行1次人工肝治疗组患者治疗后丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)高于其他组,行2~4次人工肝治疗组患者白蛋白(ALB)改善情况低于其他组,行1、2~4次人工肝治疗组患者凝血酶原时间活动度(PTA)改善情况低于其他2组,差异有统计学意义(P<0.05)。行5次人工肝治疗组患者24周生存率最高,行≥6次人工肝治疗组患者24周生存率最低。治疗前,PE组PTA低于联合组,差异有统计学意义(P<0.05);不同人工肝治疗模式组间生存率比较,差异无统计学意义(P>0.05)。14~45岁患者24周生存率最高,46~54岁患者生存率最低。结论不同人工肝治疗模式对肝衰竭患者的生存率无显著差异。行多次人工肝治疗者较单次治疗者生存率提高,且患者生存时间随治疗次数增加而延长,但超过6次治疗者生存率下降。Objective To explore the effect of the frequency and mode of artificial liver treatment on the prognosis of patients with liver failure. Methods A total of 102 patients with liver failure who received artificial liver therapy were selected as the study subjects.The 102 patients were grouped according to the number of artificial liver treatments[1 artificial liver treatment group(16 cases),2 to 4 artificial liver treatment group(69 cases),5 artificial liver treatment group(10 cases)and≥6 artificial liver treatment group(7 cases)]and the mode of artificial liver treatment group[plasma exchange(PE group,69 cases),dual plasma molecular adsorption system group(DPMAS group,2 cases)and combination group(31 cases)].M-W or K-W nonparametric tests were used for assay indexes among each group,K-M survival analysis was used for comparison of survival time of each component,and Log-rank tests were conducted in parallel.Results Alanine aminotransferase(ALT)and aspartate aminotransferase(AST)in the 1 artificial liver treatment group were significantly higher than those in other groups,and the improvement of albumin(ALB)in the 2 to 4 artificial liver treatment group was significantly lower than that in the other groups,the improvement of prothrombin time activity(PTA)in the artificial liver treatment group after 1 time,2 to 4 times was significantly lower than that in the other two groups(P<0.05).The 24-week survival rate was the highest in the group receiving 5 times of artificial liver treatment,and the lowest in the group receiving≥6 times of artificial liver treatment.Before treatment,PTA was significantly lower in the PE group than the combined group(P<0.05);there was no significant difference in survival rate among different artificial liver treatment modes(P>0.05).The 24-week survival rate was the highest in patients aged 14 to 45 years and the lowest in patients aged 46 to 54 years.Conclusion There is no significant difference in survival rate of patients with liver failure in different artificial liver treatment mod

关 键 词：人工肝 肝衰竭 预后 血浆置换 双重血浆分子吸附系统 

分 类 号：R575.3[医药卫生—消化系统] R246.1[医药卫生—内科学]