双重血浆分子吸附系统联合血液滤过治疗慢加急性肝衰竭患者的效果  

Effects of double plasma molecular adsorption system combined with hemofiltration in treatment of patients with acute-on-chronic liver failure

作　　者：邱兴迪 QIU Xingdi(Third Ward of Department of Gastroenterology of the First Affiliated Hospital of Nanyang Medical College,Nanyang 473007 Henan,China)

机构地区：[1]南阳医学高等专科学校第一附属医院消化内科三病区,河南南阳473007

出　　处：《中国民康医学》2025年第9期56-59,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察双重血浆分子吸附系统(DPMAS)联合血液滤过治疗慢加急性肝衰竭(ACLF)患者的效果。方法:选取2019—2022年该院收治的76例ACLF患者进行前瞻性研究,按随机数字表法将其分为对照组(n=38)和研究组(n=38)。对照组采用血浆置换联合血液滤过治疗,研究组采用DPMAS联合血液滤过治疗,比较两组临床疗效,治疗前后炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、肝功能指标[天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)]水平,以及不良反应发生率。结果:研究组治疗总有效率为76.32%(29/38),高于对照组的52.63%(20/38),差异有统计学意义(P<0.05);治疗后,两组IL-6、TNF-α水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);治疗后,两组AST、ALT、TBIL水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:DPMAS联合血液滤过治疗ACLF患者可提高治疗总有效率,以及降低炎性因子和肝功能指标水平的效果优于血浆置换联合血液滤过治疗。Objective:To observe effects of dual plasma molecular adsorption system(DPMAS)combined with hemofiltration in treatment of patients with acute-on-chronic liver failure(ACLF).Methods:A prospective study was conducted on 76 patients with ACLF admitted to the hospital from 2019 to 2022.According to the random number table method,they were divided into control group(n=38)and study group(n=38).The control group was treated with plasma exchange combined with hemofiltration,while the study group was treated with DPMAS combined with hemofiltration.The clinical efficacy,the levels of inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]and liver function indexes[aspartate aminotransferase(AST),alanine aminotransferase(ALT),total bilirubin(TBIL)]before and after the treatment,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the study group was 76.32%(29/38),which was higher than 52.63%(20/38)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of IL-6 and TNF-αin the two groups were lower than those before the treatment,those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of AST,ALT and TBIL in the two groups were lower than those before the treatment,those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:DPMAS combined with hemofiltration in the treatment of the ACLF patients can improve the total effective rate of treatment,and reduce the levels of inflammatory factors and liver function indexes.Moreover,it is superior to plasma exchange combined with hemofiltration.

关 键 词：慢加急性肝衰竭 双重血浆分子吸附系统 血液滤过 血浆置换 肝功能 炎性因子 不良反应 

分 类 号：R575.3[医药卫生—消化系统]