摘要
目的:探讨双重血浆分子吸附系统(DPMAS)治疗抗结核药物所致急性肝衰竭的疗效及安全性。方法:收集2017年7月—2019年7月我院收治的结核药物所致的急性肝衰竭患者40例为观察对象,随机分为对照组(内科常规药物治疗)和联合组(内科常规药物治疗联合DPMAS)各20例,分析两组临床效果及副作用。结果:(1)治疗1周后,联合组总胆红素、直接胆红素、血氨、PCT、CRP均明显下降,与对照组比较差异有统计学意义(P<0.05);两组患者凝血酶原活动度无明显变化,差异无统计学意义(P>0.05);(2)接受DPMAS治疗的20例患者,有3例出现短期发热,余均未出现严重并发症;(3)联合组1个月死亡率、6个月死亡率与对照组比较,差异无统计学意义(P>0.05);两组患者3个月死亡率比较,联合组死亡率低于对照组(P<0.05);(4)适宜在抗结核药物所致急性肝衰竭的早、中期行DPMAS治疗,晚期行DPMAS疗效差,且风险高。结论:DPMAS是治疗抗结核药物所致急性肝衰竭较好的方法,近期疗效显著,适宜在早、中期治疗,安全有效,值得在临床推广应用。
Objective:This paper is aimed to evaluate the efficacy,safety and efficacy of DPMAS in acute liver failure induced by tuberculosis management.Methods:20 cases of acute liver failure from July 2017 to July 2019 induced by tuberculosis management were selected,and were randomly assigned to control group(conventional medicine)and combined group(conventional medicine combined with DPMAS)with 20 cases each,The clinical effects and side effects of the two groups were analyzed.Results:(1)After one week of treatment,total bilirubin,direct bilirubin,blood ammonia,PCT,CRP in the combined group were significantly lower than those in the control group(P<0.05).There was no significant change in prothrombin activity in the two groups;(2)Among the 20 patients with DPMAS,3 had short-term fever and the others had no serious complications;(3)The one-month mortality rate and the six-month mortality rate of the combined group were higher than those of the control group(P>0.05),while the three-month mortality of the two groups was lower than that of the control group(P<0.05);(4)DPMAS is appropriate in the early term for tuberculosis management induced acute liver failure,and DPMAS is less effective in the late term and carries a higher risk.Conclusion:DPMAS is a safe and effective method for the treatment of acute liver failure caused by tuberculosis management,which has obvious short-term effect and is suitable for treatment in the early and middle stages.
作者
更藏尖措
颜小明
汪祖兰
苏严霖
吴学荣
Gengzang Jiancuo;Yan Xiaoming;Wang Zulan;Su Yanlin;Wu Xuerong(The Fourth People's Hospital of Qinghai,Xining Qinghai,810000)
出处
《青海医药杂志》
CAS
2021年第7期1-5,共5页
Qinghai Medical Journal
基金
吴阶平基金会肝病学部肝功能评估方法研究基金项目(LDW JPMF-104-2017009)
