双重血浆分子吸附术联合低置换量血浆置换术对慢加急性肝衰竭患者CRP、IL-6及Th1/Th2型细胞因子水平的影响  

Effects of Double Plasma Molecular Adsorption Combined with Low Displacement Plasma Exchange on CRP,IL-6 and Th1/Th2 Cytokines Levels in Patients with Acute-on-chronic Liver Failure

作　　者：陶志强 周腾 TAO Zhiqiang;ZHOU Teng(Department of Critical Care Medicine,the Fifth People's Hospital of Suzhou,Suzhou 215600,China;不详)

机构地区：[1]苏州市第五人民医院重症医学科,江苏苏州215600

出　　处：《中国医学创新》2024年第26期149-153,共5页Medical Innovation of China

摘　　要：目的:探讨双重血浆分子吸附术(DPMAS)联合低置换量血浆置换术(LPE)治疗慢加急性肝衰竭(ACLF)的效果及对C反应蛋白(CRP)、白细胞介素-6(IL-6)、Th1/Th2型细胞因子水平的影响。方法:选择2021年10月—2023年10月苏州市第五人民医院收治的ACLF住院患者90例,按随机数字表法分为观察组、对照组,各45例。对照组患者单纯应用LPE治疗,观察组患者应用DPMAS联合LPE治疗,疗程均为2周。对比治疗前后两组肝功能[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、凝血酶原活动度(PTA)]、炎症因子(CRP、IL-6)、Th1/Th2型细胞因子[γ干扰素(IFN-γ)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)],并记录两组治疗期间不良反应发生情况。结果:治疗2周后,两组ALT、AST、TBIL、CRP、IL-6、IFN-γ、TNF-α均较治疗前低,且观察组均较对照组低(P<0.05);治疗2周后,两组IL-10均升高,且观察组较对照组高(P<0.05);观察组不良反应发生率低于对照组(P<0.05)。结论:针对ACLF患者,采取DPMAS联合LPE治疗,可显著改善患者肝功能,降低炎症因子水平,改善Th1/Th2型细胞因子水平,且可降低不良反应发生率。Objective:To investigate the effect of double plasma molecular adsorption(DPMAS)combined with low displacement plasma exchange(LPE)on acute-on-chronic liver failure(ACLF)and its influence on the levels of C reactive protein(CRP),interleukin-6(IL-6)and Th1/Th2 cytokines.Method:A total of 90 patients with ACLF admitted to the Fifth People's Hospital of Suzhou from October 2021 to October 2023 were selected and divided into observation group and control group according to random number table method,with 45 cases in each group.Patients in the control group were treated with LPE alone,and patients in the observation group were treated with DPMAS combined with LPE.The course of treatment was 2 weeks.Liver function[alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),prothrombin activity(PTA)],inflammatory factors(CRP,IL-6),Th1/Th2 cytokines[interferon-γ(IFN-γ),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)]before and after treatment were compared between the two groups,and the occurrence of adverse reactions during treatment in the two groups were recorded.Result:After 2 weeks of treatment,ALT,AST,TBIL,CRP,IL-6,IFN-γ,TNF-α in both groups were lower than those before treatment,and those in the observation group were lower than those in the control group(P<0.05).After 2 weeks of treatment,IL-10 in both groups were increased,and that in the observation group was higher than that in the control group(P<0.05).The incidence of adverse reactions in observation group was lower than that in control group(P<0.05).Conclusion:For ACLF patients,DPMAS combined with LPE can significantly improve the liver function,reduce the levels of inflammatory factors,improve the levels of Th1/Th2 cytokines,and reduce the incidence of adverse reactions.

关 键 词：慢加急性肝衰竭 双重血浆分子吸附术 低置换量血浆置换术 肝功能 炎症因子 Th1/Th2型细胞因子 

分 类 号：R575.3[医药卫生—消化系统]