两种人工肝方法治疗重型乙型肝炎的近期疗效对比分析

发布时间：2018-05-15 01:39

本文选题：肝 + 人工　；参考：《重庆医学》2017年18期

【摘要】：目的探讨血浆置换(PE)与PE联合双重血浆分子吸附系统(PE+DPMAS)治疗重型乙型肝炎(SHB)的近期疗效。方法回顾性分析70例SHB患者的临床资料,按照治疗方式不同分为PE组和PE+DPMAS组,比较两组患者治疗前、后的临床症状,肝功能、凝血功能、血常规、肾功能及电解质变化情况,以及终末期肝病模型(MELD)评分下降情况。结果两组患者治疗后消化道症状都有所改善,肝性脑病级别降低,MELD评分下降,两组患者近期有效率比较差异无统计学意义(P0.05)。与治疗前比较,治疗后两组患者的血清总胆红素(TBIL)、丙氨酸转氨酶(ALT)、红细胞(RBC)、血红蛋白(Hb)、血小板(PLT)均下降(P0.05);PE+DPMAS组的清蛋白(ALB)较治疗前下降,K+、Cl-升高(P0.05);PE组凝血酶原活动度(PTA)、ALB较治疗前升高,白细胞(WBC)下降(P0.05)。结论 PE、PE+DPMAS两种治疗方法治疗SHB均有效,PE+DPMAS可减少血浆用量,改善血清K~+、Cl~-水平;PE在改善凝血功能及ALB水平方面效果优于PE+DPMAS。
[Abstract]:Objective to investigate the short term effect of plasma exchange (PEV) combined with PE double molecular adsorption system (DPMASA) in the treatment of severe hepatitis B patients with SHBs. Methods the clinical data of 70 patients with SHB were retrospectively analyzed and divided into PE group and PE DPMAS group according to different treatment methods. The changes of clinical symptoms, liver function, coagulation function, blood routine, renal function and electrolyte before and after treatment were compared between the two groups. And the decline of MELDs in the model of end-stage liver disease. Results after treatment, the digestive tract symptoms of the two groups were improved, the grade of hepatic encephalopathy decreased and meld score decreased. There was no significant difference in the short-term effective rate between the two groups (P 0.05). Compared with pre-treatment, After treatment, the serum total bilirubin Tbilirubin, alanine aminotransferase (alanine aminotransferase), red blood cell (RBC), hemoglobin (HB), platelet (PLT) in the two groups were all decreased compared with those before treatment in P0.05 DPMAS group, and the prothrombin activity of P0.05PE group was higher than that of P0.05PE group. The white blood cell (WBC) decreased (P0.05). Conclusion the two treatment methods of PE DPMAS are effective in the treatment of SHB. Pe DPMAS can reduce the plasma dosage, and improve the serum level of KnCl-Pe can improve the coagulation function and the level of ALB, which is better than that of PE DPMA SSA in improving the blood coagulation function and the level of ALB.
【作者单位】：重庆医科大学附属第二医院感染科;
【基金】：重庆市卫生和计划生育委员会基金资助项目(20112154)
【分类号】：R512.62

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