摘要
目的观察人工肝血浆胆红素吸附治疗对重症乙型病毒性肝炎(乙肝)患者临床疗效的影响.方法采用回顾性研究方法,收集2015年8月至2017年8月在绵阳市中心医院感染科住院的重症乙肝行人工肝血浆胆红素吸附治疗120例患者的临床资料,其中肝硬化组68例,非肝硬化组52例.收集患者行人工肝血浆胆红素吸附治疗前后肝功能、凝血功能等指标;比较重症乙肝非肝硬化组与肝硬化组患者丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、谷氨酰转移酶(GGT)、碱性磷酸酶(ALP)、乳酸脱氢酶(LDH)、总蛋白(TP)、白蛋白(Alb)、球蛋白(Glo)、凝血酶原时间(PT)、凝血酶原活动度(PTA)、总胆红素(TBil)、间接胆红素(IBil)、总胆汁酸(TBA)水平及下降率的差异.结果人工肝血浆胆红素吸附治疗后患者ALT、AST、ALP、LDH均较治疗前明显下降〔ALT(U/L):138.8±26.2比993.4±185.2,AST(U/L):121.7±119.9比798.7±226.8,ALP(U/L):129.7±8.1比178.9±14.1,LDH(μmol/L·s^-1·L^-1):4.50±0.32比8.15±1.75,均P<0.05〕;PTA较治疗前明显升高〔(43.2±25.6)%比(30.0±16.1)%,P<0.05〕.治疗后非肝硬化组患者ALP、TBil、TBA下降率均明显高于肝硬化组(ALP:34.20%比17.80%,TBil:39.10%比18.10%,TBA:30.70%比5.00%,P<0.05),PTA升高率也明显高于肝硬化组(52.50%比25.10%,P<0.05).结论人工肝血浆胆红素吸附治疗重症乙肝特别是早期非肝硬化患者疗效良好.
Objective To observe the clinical efficacy of artificial liver plasma bilirubin adsorption for treatment of patients with severe viral hepatitis B(HB\).Methods A retrospective study was conducted,the 120 patients with severe IIBV B and their historical data of having undergone treatment of artificial liver plasma bilirubin adsorption admitted to Department of Respiration of Mianyang Central Hospital from August 2015 to August 2017 were collected,and there were 68 cases in the cirrhotic group and 52 cases in the non-cirrhotic group.The inflexes of liver function ami coagulation function before and after the treatment of artificial liver plasma bilirubin adsorption were collected;the differences of alanine aminotransferase(ALT),aspartate aminotransferase(AST),glutamine transferase(GOT),alkaline phosphatase(ALP),lactate dehydrogenase(LDH),total protein(TP),albumin(Alb),globulin(Glo),prothrombin time(PT),prothrombin activity(PTA),total bilirubin(TBil)and indirect bilirubin(IBil),total bile acid(TBA),etc were compared between cirrhotic group and the severe hepatitis B non-cirrhotic group.Results The levels of ALT.AST.ALP,LDH after artificial liver plasma bilirubin adsorption therapy were lower than those before the treatment[ALT(U/L):138.8±26.2 vs.993.4±185.2.AST(U/L):121.7±119.9 vs.798.7±226.8,ALP(ll/L):129.7±8.1 vs.178.9±14.1.LDH(μmol/L·s^-1·L^-1):4.50±0.32 vs.8.15±1.75,all P<0.05],PTA was higher than that before the treatment[(43.2±25.6)%vs.(30.0±16.1)%,P<0.05],After the treatment,the decline rate of ALP,TBil,and TBA of non-cirrhotic group was higher than those in cirrhotic group(ALP:34.20%vs.17.80%,TBil:39.10%vs.18.10%.TBA:30.70%vs.5.00%,P<0.05),the elevation rate of PTA in non-cirrhotic group was also higher than that in cirrhotic group(52.50%vs.25.10%,P<0.05).Conclusion Artificial liver plasma bilirubin adsorption therapy is effective for treatment of patients with severe HBY B,particularly the effect being good on the early severe viral HBY B non-cirrhotic group.
作者
郭建英
陈泠忻
杨蕊西
阮军
刘茗心
寇国先
Guo Jianying;Chen Lingxin;Yang Ruixi;Ruan Jun;Liu Mingxin;Kou Guoxian(Department of Respiration,Mianyang Central Hospital,Mianyang 621000,Sichuan,China;Department of Infectious Disease,Mianyang Central Hospital,Mianyang 621000,Sichuan,China)
出处
《中国中西医结合急救杂志》
CAS
CSCD
北大核心
2019年第1期62-64,共3页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
关键词
人工肝
血浆胆红素吸附
重症乙型病毒性肝炎
肝硬化
丙氨酸转氨酶
胆红素
Artificial liver
Plasma bilirubin adsorption
Yirus hepatitis B,severe
Cirrhosis
Alanine aminotransferase
Bilirubin
