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目的评价缓慢血浆置换(SPE)联合猪肝细胞中空纤维管型生物人工肝(BLSS)、SPE与血液透析(HD)联合猪肝细胞中空纤维管型 BLSS 治疗早期慢性重型肝炎的临床疗效。方法选取120例早期慢性重型肝炎患者,随机平均分为4组:SPE+BLSS 治疗组、SPE+HD+BLSS 治疗组、SPE 治疗组和药物治疗对照组。观察各组治疗前、治疗后即刻、治疗后72 h、治疗后2周的临床症状、血清总胆红素、血清白蛋白、凝血酶原活动度、血清内毒素、胆碱酯酶、甲胎蛋白变化情况。结果与药物对照组比较,治疗组患者的血清总胆红素和血清内毒素明显降低(P<0.05),血清白蛋白、凝血酶原活动度、胆碱酯酶和甲胎蛋白增高(P<0.05),临床症状明显减轻。SPE+BLSS、SPE+HD+BLSS 和 SPE 治疗组早期慢性重型肝炎的治愈好转率分别为83.3%(25/30)、90%(27/30)和70%(21/30),不良反应发生例次为9/182。药物对照组早期慢性重型肝炎治愈好转率为50%(15/30)。结论 SPE+BLSS、SPE+HD+BLSS 组成的两种混合型生物人工肝系统对早期慢性重型肝炎临床疗效显著,安全性好;SPE+HD+BLSS 疗效优于 SPE+BLSS。
Objective To evaluate the clinical efficacy of slow plasmapheresis (SPE) in combination with hollow fiber tubular bioartificial liver (BLSS) in pig hepatocytes, and SPE and hemodialysis (HD) in combination with hollow fiber tube BLSS of swine hepatocytes in the treatment of early-stage chronic severe hepatitis. Methods One hundred and twenty patients with early-stage chronic severe hepatitis were randomly divided into four groups: SPE + BLSS group, SPE + HD + BLSS group, SPE group and drug-treated group. The clinical symptoms, serum total bilirubin, serum albumin, prothrombin activity, serum endotoxin, cholinesterase, and alpha-fetoprotein in each group before treatment, immediately after treatment, 72 h after treatment and 2 weeks after treatment were observed. Protein changes. Results Compared with the control group, the levels of serum total bilirubin and endotoxin were significantly decreased (P <0.05), serum albumin, prothrombin activity, cholinesterase and alpha-fetoprotein were increased in the treatment group (P < 0.05), clinical symptoms significantly reduced. The improvement rates of early chronic severe hepatitis in the SPE + BLSS, SPE + HD + BLSS and SPE groups were 83.3% (25/30), 90% (27/30) and 70% (21/30), respectively. Adverse reactions occurred The number of cases is 9/182. Drug control group early chronic severe hepatitis cure improvement rate was 50% (15/30). Conclusions The two mixed bioartificial liver systems composed of SPE + BLSS and SPE + HD + BLSS have significant clinical efficacy and safety for early-stage chronic severe hepatitis. The effect of SPE + HD + BLSS is better than that of SPE + BLSS.