摘要
目的分析不同人工肝组合模式在治疗肝衰竭合并肝性脑病中的临床价值。方法选取2022年1—12月九江市第三人民医院收治的100例肝衰竭合并肝性脑病患者作为研究对象,按照随机数字表法分为A组与B组,每组50例。A组接受双重血浆分子吸附系统(dual plasma molecular adsorption system,DPMAS)+血浆置换(plasma exchange,PE)]治疗,B组接受血液透析滤过(hemodialysis filtration,HDF)+DPMAS治疗。比较两组血清生化指标[总胆红素(total bilirubin,TBiL)、天冬氨酸转氨酶(aspartate aminotransferase,AST)、丙氨酸转氨酶(alanine aminotransferase,ALT)、甘油三酯(triglyceride,TG)、总胆汁酸(total bile acid,TBA)、胆碱酯酶(cholinesterase,CHE)、肌酐(creatinine,Cr)、尿素氮(urea nitrogen,BUN)、钾离子、钠离子、国际标准化比值(international normalized ratio,INR)、凝血酶原时间(prothrombin time,PT)、凝血酶原活动度(prothrombin activity,PTA)、甲胎蛋白(alpha fetoprotein,AFP)、血小板计数(platelet count,PLT)、WBC、中性粒细胞百分比(percentage of neutrophils,NEU)、乙型肝炎病毒DNA(hepatitis B virus DNA,HBV-DNA)、血氨(blood ammonia,NH3)]及体征缓解情况。结果治疗后,两组TBiL、AST、ALT、TG、TBA、Cr、BUN、钾离子、INR、AFP、PLT、WBC、NEU、HBV-DNA、血NH3均低于治疗前,PT均短于治疗前,CHE、钠离子、PTA均高于治疗前,B组TBiL、AST、ALT、TG、TBA、Cr、BUN、INR、AFP、PLT、WBC、NEU、HBV-DNA、血NH3均低于A组,PT长于A组,CHE、钾离子、钠离子、PTA均高于A组,差异有统计学意义(P<0.05)。B组体征缓解总有效率高于A组,差异有统计学意义(P<0.05)。结论DF+DPMAS治疗能有效地改善肝衰竭合并肝性脑病患者的生化指标,缓解临床症状,具有较高的临床应用价值。
Objective To analyze the clinical value of different artificial liver combination modes in the treatment of liver failure complicated with hepatic encephalopathy.Methods 100 patients with liver failure and hepatic encephalopathy admitted to the Jiujiang Third People's Hospital from January to December 2022 were selected as the research subjects,and they were divided into the group A and the group B by random number table method,with 50 cases in each group.The group A received treatment with dual plasma molecular adsorption system(DPMAS)combined with plasma exchange(PE),while the group B received hemodialysis filtration(HDF)combined with DPMAS treatment.The serum biochemical indexes(total bilirubin[TBiL],aspartate aminotransferase[AST],alanine aminotransferase[ALT],triglyceride[TG],total bile acid[TBA],cholinesterase[CHE],creatinine[Cr],urea nitrogen[BUN],potassium ion,sodium ion,international normalized ratio[INR],prothrombin time[PT],prothrombin activity[PTA],alpha fetoprotein[AFP],platelet count[PLT],WBC,percentage of neutrophils[NEU],hepatitis B virus DNA[HBV-DNA],blood ammonia[NH3])and the relief of symptoms and signs were compared between the two groups.Results After treatment,TBiL,AST,ALT,TG,TBA,Cr,BUN,potassium ion,INR,AFP,PLT,WBC,NEU,HBV-DNA and blood NH3 of the two groups were lower than those before treatment,PT was shorter than that before treatment,CHE,sodium ion and PTA were higher than those before treatment,TBiL,AST,ALT,TG,TBA,Cr,BUN,INR,AFP,PLT,WBC,NEU,HBV-DNA and blood NH3 in the group B were lower than those in the group A,PT was longer than that in group A,CHE,potassium ion,sodium ion and PTA were higher than those in the group A,the differences were statistically significant(P<0.05).The total effective rate of signs in the group B was higher than that in the group A,the difference was statistically significant(P<0.05).Conclusion DF+DPMAS treatment can effectively improve the biochemical indexes of patients with liver failure complicated with hepatic encephalopathy,relieve clinical symptoms and signs,and has high clinical application value.
作者
沃琤
沈国俊
曾刚
WO Cheng;SHEN Guojun;ZENG Gang(Department of Hepatic,Jiujiang Third People's Hospital,Jiujiang,Jiangxi,332000,China)
出处
《当代医学》
2024年第36期154-157,共4页
Contemporary Medicine
基金
北京肝胆相照公益基金会人工肝专项基金(iGandanF-1082022-RGG0366)。
关键词
双重血浆分子吸附系统
血浆置换
血液透析滤过
肝性脑病
Dual plasma molecular adsorption system
Plasma exchange
Hemodialysis filtration
Hepatic encephalopathy
