DPMAS治疗药物性肝损伤伴严重高胆红素血症患者临床疗效研究  

Clinical efficacy analysis of DPMAS in the treatment of drug-induced liver injury with severe hyperbilirubinemia

作　　者：黄蝶 张鑫赫 佟静[1] 常冰[1] 关琳[1] 王宁宁[1] 李异玲[1] HUANG Die;ZHANG Xinhe;TONG Jing;CHANG Bing;GUAN Lin;WANG Ningning;LI Yiling(Department of Gastroenterology,the First Affiliated Hospital of China Medical University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院消化内科,辽宁沈阳110001

出　　处：《胃肠病学和肝病学杂志》2024年第2期125-128,共4页Chinese Journal of Gastroenterology and Hepatology

基　　金：北京肝胆相照公益基金会人工肝专项基金资助项目(RGGJJ-2021-020/iGandanF-1082022-RGG018)。

摘　　要：目的分析双重血浆分子吸附系统(double plasma molecular adsorption system,DPMAS)治疗药物性肝损伤(drug-induced liver injury,DILI)伴严重高胆红素血症患者的临床疗效。方法收集2021年4月至2022年4月我院诊治的DILI伴严重高胆红素血症患者60例,随机分为观察组30例和对照组30例。对照组给予传统内科治疗,观察组在传统内科治疗基础上行DPMAS治疗。比较两组治疗前后临床症状、实验室指标的变化情况,观察两组治疗有效率及疗效差异。结果引起肝损伤的主要药物包括中药、解热镇痛药、化疗药物等;DILI损伤类型包括肝细胞损伤型、胆汁淤积型、混合型;治疗后,观察组和对照组AST、ALT、ALP、TBA、TBIL、DBIL较两组治疗前显著降低(P<0.05);观察组PT和INR较治疗前降低,而ALB和PTA较治疗前升高(P<0.05);两组治疗后肝肾功能和凝血功能比较,差异无统计学意义(P>0.05)。治疗后,两组有效率比较,差异无统计学意义(P>0.05)。观察组TBIL下降率达30%、50%和70%所需的治疗时间均显著短于对照组(P<0.05),同时观察组TBIL和DBIL总下降率显著高于对照组(P<0.05)。结论DPMAS治疗DILI伴严重高胆红素血症患者的临床疗效显著,可以快速降低胆红素并缩短病程。Objective To analyze the clinical efficacy of double plasma molecular adsorption system(DPMAS)in the treatment of patients with drug-induced liver injury(DILI)with severe hyperbilirubinemia.[WTHZ]Methods sixty patients with DILI with severe hyperbilirubinemia were enrolled in our hospital from Apr.2021 to Apr.2022,and they were randomly divided into control group and observation group,with 30 cases in each group.The patients in the control group were given conventional medical treatment,and the patients in the observation group were received DPMAS in base of traditional medical treatment.The clinical symptoms and laboratory indicators before and after treatment were compared between the two groups,and the differences of treatment efficiency and efficacy were analyzed.[WTHZ]Results The main drugs causing liver injury were traditional Chinese medicine,antipyretic analgesic and chemotherapy drugs.The types of DILI were hepatocyte injury type,cholestatic type and mixed type.After the end of treatment,AST,ALT,ALP,TBA,TBIL and DBIL in observation group and control group were significantly decreased than before treatment(P<0.05).Serum PT and INR in observation group were decreased than before treatment,while ALB and serum PTA were increased than before treatment(P<0.05).There were no significant differences in hepatic,renal and coagulation function between the two groups after treatment(P>0.05).After treatment,the effective rate was no significant difference between two groups(P>0.05).The treatment time for 30%,50%and 70%TBIL reduction rates in the observation group were significantly shorter than those in control group(P<0.05),and the total reduction rates of TBIL and DBIL in the observation group were significantly higher than those in control group(P<0.05).[WTHZ]Conclusion DPMAS is effective in the treatment of DILI with severe hyperbilirubinemia,which can rapidly reduce bilirubin and shorten the course of disease.

关 键 词：药物性肝损伤 高胆红素血症 双重血浆分子吸附系统 疗效 

分 类 号：R575[医药卫生—消化系统]