| 唐碧波,戴丽星,胡东辉,戴 丹,余世敏.血浆置换与血浆灌流联合治疗肝衰竭的疗效及对炎症因子及肝功能的影响[J].,2017,17(25):4904-4907 |
| 血浆置换与血浆灌流联合治疗肝衰竭的疗效及对炎症因子及肝功能的影响 |
| Efficacy of Plasma Exchange Combined with Plasma Perfusion in Treatment of Liver Failure and the Influence on Inflammatory Factors and Liver Function |
| 投稿时间：2017-01-06 修订日期：2017-01-30 |
| DOI：10.13241/j.cnki.pmb.2017.25.025 |
| 中文关键词: 肝衰竭 血浆置换 血浆灌注 炎症因子 |
| 英文关键词: Liver failure Plasma exchange Plasma perfusion Inflammatory factors |
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| 中文摘要: |
| 摘要 目的：探讨血浆置换（PE）与血浆灌流（PP）联合治疗肝衰竭的疗效和安全性，以及其对炎症因子和肝功能的影响。方法：选择2014年2月至2016年2月我院收治的98例肝衰竭患者为研究对象，按随机数字表法分为实验组和对照组，每组各49例。实验组行PE联合PP治疗，对照组行单纯PE治疗。采用全自动生化分析仪检测治疗前后患者肝功能指标；采用酶联免疫吸附法（ELISA）检测血清中炎症因子C-反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、白介素-6（IL-6）水平。对比两组患者临床总有效率、不良反应发生率以及治疗前后肝功能指标和炎症因子水平。结果：实验组临床总有效率为91.84%，显著高于对照组的73.47%，差异有统计学意义（P＜0.05）。实验组不良反应发生率为10.20%，明显低于对照组的38.78%，差异有统计学意义（P＜0.05）。治疗后两组患者血清谷丙转氨酶（ALT）、总胆红素（TBIL）和血氨（NH3）水平明显下降（均P＜0.05），白蛋白（ALB）和凝血酶活动度（PTA）明显上升（均P＜0.05），治疗后实验组血清ALT、TBIL和NH3水平均低于对照组，ALB和PTA水平均高于对照组，差异具有统计学意义（均P＜0.05）。治疗后血清中炎症因子CRP、TNF-α、IL-6水平均低于治疗前，实验组血清CRP、TNF-α、IL-6水平均低于对照组（均P＜0.05）。结论：PE与PP联合治疗肝衰竭具有较好的疗效，且不良反应发生率较低，可有效清除炎症因子，改善肝功能，提高患者生存质量。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the efficacy and safety of plasma exchange (PE) combined with plasma perfusion (PP) in treatment of liver failure and the influence on inflammatory factors and liver function. Methods: 98 patients with liver failure in our hospital from February 2014 to February 2016 were selected as the subjectswere, and they were randomly divided into experimental group and control group, and each group was 49 cases. The experimental group was treated with PE combined with PP, and the control group was received PE alone. The liver function before and after treatment was detected by automatic biochemical analyzer. The serum levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were determined by enzyme-linked immunosorbent assay (ELISA). The total effective rate, the incidence of side effects, the levels of liver function and inflammatory factors before and after treatment were compared between the two groups. Results: The clinical effective rate in the experimental group (91.84%) was significantly higher than that in the control group (73.47%), the difference was statistically significant (P<0.05). The incidence of adverse reactions in the experimental group (10.20%) was significantly lower than that in the control group (38.78%), the difference was statistically significant (P<0.05). The levels of serum alanine aminotransferase (ALT), total bilirubin (TBIL) and blood ammonia (NH3) were significantly decreased in both groups after treatment (all P<0.05). Albumin (ALB) and thrombin activity (PTA) were significantly increased in both groups after treatment (both P<0.05). After treatment, the serum levels of ALT, TBIL and NH3 in the experimental group were lower than those in the control group (all P<0.05), the levels of ALB and PTA were higher than those of the control group, the difference was statistically significant (both P<0.05). After treatment, the serum levels of CRP, TNF-α and IL-6 were lower than those before treatment, and the serum levels of CRP, TNF-α and IL-6 in the experimental group were lower than those in the control group (all P<0.05). Conclusion: The combination of plasma exchange and plasma perfusion has a good effect in the treatment of liver failure, and the incidence of adverse reactions is low. It can effectively remove inflammatory factors,improve liver function and improve the quality of life of patients. |
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