双重血浆分子吸附系统治疗乙肝慢加急肝衰竭患者疗效及其对T淋巴细胞亚型的影响

发布时间：2018-10-14 08:54

【摘要】：目的观察双重血浆分子吸附系统(DPMAS)治疗乙肝慢加急肝衰竭(AoCLF)患者的疗效及对外周血T淋巴细胞亚型的影响。方法 2013年1月一2015年1月成都市公共卫生临床医疗中心传染科治疗HBV-AoCLF患者42例,根据是否接受DPMAS治疗分为DPMAS组(n=10)、血浆置换组(PE组,n=16)和对照组(n=16)。比较治疗前和治疗后1周外周血T淋巴细胞指标改变与临床预后的关系。结果 DPMAS组28天病死率明显低于对照组(10.0%vs.37.5%,P0.05)。治疗后,DPMAS组患者CD4~+和CD4~+/CD8~+水平明显上升(P0.05),而CD8~+水平明显下降(P0.05),且明显优于PE组及对照组(P0.05)。生存亚组患者CD4~+和CD4~+/CD8~+水平明显上升,CD8~+水平明显下降(P0.05),而死亡亚组上述指标均无显著变化(P0.05)。DPMAS治疗与AoCLF患者28天死亡事件存在负相关(r=-0.683,P=0.01),与△CD4~+、△CD8~+和△CD4~+/CD8~+呈正相关(r=0.712,P=0.02;r=0.650,P=0.02;r=0.598,P=0.04)。DPMAS治疗后30天死亡风险明显降低(P0.05)。结论 DPMAS治疗可以通过改善HBV相关AoCFL患者血清T细胞亚型分布,进而提高生存率。
[Abstract]:Objective to observe the therapeutic effect of double plasma molecular adsorption system (DPMAS) on (AoCLF) patients with chronic hepatitis B and acute liver failure and its effect on T lymphocyte subtypes in peripheral blood. Methods from January 2013 to January 2015, 42 patients with HBV-AoCLF were treated by infectious department of Chengdu Public Health Clinical Medical Center. According to whether they received DPMAS treatment, 42 patients were divided into three groups: DPMAS group (n = 10), plasma exchange group (PE group, n = 16) and control group (n = 16). To compare the relationship between the changes of peripheral blood T lymphocytes and clinical prognosis before treatment and 1 week after treatment. Results the fatality rate of 28 days in DPMAS group was significantly lower than that in control group (10.0 vs 37.5% P0.05). After treatment, the levels of CD4~ and CD4~ / CD8~ in DPMAS group increased significantly (P0.05), while CD8~ level decreased significantly (P0.05), which was significantly better than that in PE group and control group (P0.05). In the survival subgroup, the levels of CD4~ and CD4~ / CD8~ increased significantly, and the CD8~ level decreased significantly (P0.05), but there was no significant change in the above indexes in the death subgroup (P0.05). (P0.05) there was a negative correlation between). DPMAS treatment and the death events of AoCLF patients at 28 days (r-0.683, P0. 01), but there was no significant difference between). DPMAS treatment and CD4~. There was a positive correlation between CD8~ and CD4~ / CD8~ (r = 0.712). The risk of death was significantly decreased 30 days after treatment (P 0.05). Conclusion DPMAS therapy can improve the distribution of T cell subtypes in patients with HBV associated AoCFL and improve the survival rate.
【作者单位】：成都市公共卫生临床医疗中心传染科;
【分类号】：R512.62;R575.3

【相似文献】