LPE联合DPMAS治疗ACLF患者的临床效果及对IFN-γ、IL-6、MELD评分的影响  

Clinical Effect of LPE Combined with DPMAS in the Treatment of Patients with ACLF and the Influence on IFN-γ,IL-6 and MELD Score

作　　者：邹波[1] 熊云逢 张鑫垚[1] 朱龙川[1] 张雪珍[1] ZOU Bo;XIONG Yunfeng;ZHANG Xinyao;ZHU Longchuan;ZHANG Xuezhen(The Ninth Hospital of Nanchang,Nanchang 330002,China;不详)

机构地区：[1]南昌市第九医院,江西南昌330002

出　　处：《中国医学创新》2023年第30期54-58,共5页Medical Innovation of China

基　　金：2022年度江西省卫生健康委科技计划项目(202211524)。

摘　　要：目的:探究慢加急性肝衰竭(ACLF)患者采用低容量血浆置换(LPE)联合双重血浆分子吸附系统(DPMAS)治疗的临床效果及对干扰素-γ(IFN-γ)、白介素-6(IL-6)、终末期肝病模型(MELD)评分的影响。方法:纳入的90例ACLF患者选自南昌市第九医院2021年1月—2022年10月收治。依据随机数字表法将其分为对照组、观察组,各45例。两组均给予常规药物治疗,对照组在上述基础实施血浆置换(PE)治疗,观察组实施LPE+DPMAS治疗,比较两组临床疗效、肝功能、IFN-γ、IL-6和MELD评分。分析不良反应发生情况。结果:观察组临床总有效率(91.11%)较对照组(71.11%)显著增高(P<0.05)。治疗前,两组血清丙氨酸氨基转移酶(ALT)、总胆红素、直接胆红素水平对比,差异均无统计学意义(P>0.05);治疗后,两组上述指标均降低,且观察组均低于对照组(P<0.05)。治疗前,两组IFN-γ、IL-6、MELD评分比较,差异均无统计学意义(P>0.05);治疗后,两组上述指标均下降,且观察组较对照组均更低(P<0.05)。观察组及对照组不良反应总发生率分别为11.11%、8.89%,差异无统计学意义(χ^(2)=0.124,P>0.05)。结论:ACLF患者应用LPE联合DPMAS治疗,效果显著,可改善肝功能,降低IFN-γ、IL-6水平及MELD评分,且安全性良好。Objective:To explore the clinical effect of low-volume plasma exchange(LPE)combined with dual plasma molecular adsorption system(DPMAS)in the treatment of patients with acute-on-chronic liver failure(ACLF)and the influence on interferon-γ(IFN-γ),interleukin-6(IL-6)and the model of end-stage liver disease(MELD)score.Method:A total of 90 patients with ACLF admitted to the Ninth Hospital of Nanchang from January 2021 to October 2022 were selected.According to random number table method,the subjects were divided into control group and observation group,with 45 cases in each group.Both groups were treated with conventional drugs,on this basis of the above,the control group was treated with plasma exchange(PE),while the observation group was treated with LPE and DPMAS.Clinical effect,liver function,IFN-γ,IL-6 and MELD scores were compared between groups.The occurrence of adverse reactions was statistically analyzed.Result:The total clinical effective rate in the observation group(91.11%)was significantly higher than that in the control group(71.11%)(P<0.05).Before treatment,there were no significant differences in serum alanine aminotransferase(ALT),total bilirubin,direct bilirubin between the two groups(P>0.05);after treatment,the above indexes were decreased in both groups,and those in observation group were lower than those in the control group(P<0.05).Before treatment,there were no significant differences in IFN-γ,IL-6 and MELD score between the two groups(P>0.05);after treatment,the above indexes were decreased in both groups,and those in observation group were lower than those in the control group(P<0.05).The total incidence rates of adverse reactions in the observation group and the control group were 11.11%and 8.89%,the difference was not statistically significant(χ^(2)=0.124,P>0.05).Conclusion:Curative effect of LPE combined with DPMAS is significant on ACLF patients,which can improve liver function,reduce IFN-γ,IL-6 levels and MELD score,with good safety.

关 键 词：慢加急性肝衰竭 低血容量血浆置换 双重血浆分子吸附系统 干扰素-Γ 白介素-6 MELD评分 

分 类 号：R575.3[医药卫生—消化系统]