摘要
目的研究人工肝血浆置换(PE)联合血液滤过(HF)对急性肝衰竭(ALF)动物高颅压的疗效。方法10只中国实验小型猪随机分为治疗组(n=5)与对照组(n=5),采用D-氨基半乳糖(1.2g/kg)静脉注射诱导建立急性肝衰竭动物模型。治疗组分别在给药24h、48h后给予血浆置换联合血液滤过治疗,对照组未给予任何干预治疗。持续监测两组动物颅内压(ICP)变化并观察比较两组动物的肝功能、生化指标及生存时间的差异。结果经过人工肝治疗后,治疗组动物的颅内高压及多项生化指标、炎性细胞因子等较对照组明显改善(P<0.05～P<0.01);与对照组相比,治疗组动物的生存时间明显延长[分别为(125.7±12.6)h和(58.9±11.2)h,t=1.03,P<0.01]。结论血浆置换联合血液滤过的非生物型组合人工肝治疗能清除急性肝衰竭动物体内多种病理成分、改善肝功能、降低颅内高压,并能明显延长急性肝衰竭实验动物生存时间。该方法有望成为帮助急性肝衰竭患者度过危险期,并可作为肝脏移植的有效辅助手段。
Objective To study the efficacy of plasma exchange （PE） plus hemodiafiltration （HF） in the treatment of increased intracranial pressure in pig model of acute liver failure. MethodsTen minipigs were randomly enrolled into two groups： control group （n=5） and treatment group （n=5）.ALF was induced by administration of D-galactosamine （dosage： 1.2g/kg）. After 24 and 48 hours the treatment group were treated with PE combined with HF, while the control group were not treated. Intracranial pressure（ICP） was monitored continuously. And the liver function, seram tumor necrosis factor （TNF-a）, interleulin-1（IL-1）, interleulin-6（IL-6）, endotoxin, nitric oxide （NO）, middle molecule substances （MMS）and survival time were observed. Results After treating with artificial liver support system, the liver functions of the treatment group were ameliorated（P〈0. 05-0. 01）. The intracranial hypertension and biochemical parameters decreased obviously（P〈0.05-0. 01）. The treatment group＇s mean survival time was （125.7 ± 12.6） hours, which was longer than the control group[（58.9±11.2） hours]. Conclusions PE plus HF may significantly decrease the levels of pathologic components, ameliorate liver function, decrease intracranial pressure and prolong the survial time. PE plus HF were effective in treatment of patients with acute liver failure.
出处
《中国血液净化》
2006年第5期256-259,共4页
Chinese Journal of Blood Purification
基金
2003BA753C北京市科委重大科研攻关项目:重型肝炎肝衰竭人工肝治疗研究
关键词
人工肝支持系统
血浆置换
血液滤过
急性肝衰竭
颅内压
Artificial liver support system
Plasma exchange
Hemodiafiltration
Acute liver failure
Intracranial pressure
