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目的 :探讨人工肝支持系统 (ALSS)血浆置换 (PE)治疗重型病毒性肝炎的疗效。方法 :重型肝炎 139例 ,设治疗组及对照组 ,两组均采用重型肝炎的常规治疗 ,治疗组同时加用PE治疗 ,并检测治疗前后肝功能、血氨、血清HBV -DNA定量、肾功、电解质、观察临床症状体征及预后。结果 :PE治疗后肝功能明显改善 ,血氨下降由 12 7.91± 5 7.33(μmol/l)降至 81.5 1±4 0 .2 0 (μmol/l) (P <0 .0 0 1) ,血清HBV -DNA定量水平平均对数值 (Log10copy/ml)由 5 .72± 1.39降至 4 .5 3± 1.35 (P <0 .0 5 )。治疗组治愈好转率明显高于对照组 ,分别为 6 7.0 3% (6 1/ 91)、5 0 .0 % (2 4 / 4 8)P <0 .0 5 ,其中又以重型肝炎早期、中期组治愈好转率较对照组明显提高 ,分别为 95 % (19/ 2 0 )、72 .2 7% (8/ 11)及 82 .0 5 % (32 / 39)、5 7.14 (12 / 2 1)。结论 :PE治疗可提高重型肝炎疗效 ,以早、中期最为适宜 ,安全性好
Objective: To investigate the efficacy of artificial liver support system (ALSS) plasma exchange (PE) in the treatment of severe viral hepatitis. Methods: One hundred and ninety-three cases of severe hepatitis were divided into treatment group and control group. Both groups were treated with conventional treatment of severe hepatitis. The treatment group was treated with PE at the same time. The liver function, serum ammonia, serum HBV-DNA, , Electrolytes, clinical symptoms and signs and prognosis. Results: The liver function was significantly improved after PE treatment. The blood ammonia level decreased from 12 7.91 ± 5 7.33 (μmol / l) to 81.5 1 ± 4.0 0 (μmol / l) (P <0.01) The mean logarithm of HBV-DNA levels (Log10copy / ml) decreased from 5.72 ± 1.39 to 4.53 ± 1.35 (P <0.05). The treatment group improved cure rate was significantly higher than the control group, respectively, 6 7.03% (6 1/91), 50.0% (24/48) P <0. 05, which again in the early stages of severe hepatitis, The cure rate in the intermediate group was significantly higher than that in the control group (95%, 72.27%, 82.5%, 32.14%, 51.14% 1). Conclusion: PE treatment can improve the efficacy of severe hepatitis, the most suitable early and mid-term, good safety