摘要
目的观察双重血浆分子吸附系统(DPMAS)与全量血浆置换(PE)对肝衰竭高胆红素血症患者的临床疗效。方法回顾性收集徐州医科大学附属医院2020年3月—2023年3月收治的肝衰竭高胆红素血症患者的临床资料,符合纳排标准的患者133例。按患者在院期间人工肝治疗方法的不同分为两组:A组70例,采用DPMAS治疗;B组63例,采用全量血浆置换。使用倾向性匹配方法,按照1:1比例匹配两组患者的临床资料,实际配对每组各50例患者。对比两组患者临床表现、肝功能、凝血功能、炎症指标和治疗期间不良反应发生情况。结果两组治疗总有效率(80.00%vs.74.00%)无明显差异(P>0.05)。治疗后两组前白蛋白(PA)、甲胎蛋白(AFP)、PA/TB值均高于治疗前,总胆红素(TBIL)低于治疗前(P<0.05),但两组治疗后各项肝脏功能指标比较,差异无统计学意义(P>0.05)。治疗后凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)较治疗前缩短,凝血酶原活动度(PTA)增加,国际标准化比值(INR)、血清白细胞介素(IL)-6、肿瘤坏死因子(TNF-α)及超敏C反应蛋白(hs-CRP)下降(P<0.05);而两组治疗后的凝血指标、血清炎症指标比较,无显著性差异(P>0.05)。两组治疗后不良反应比较无显著性差异(P>0.05)。结论与全量血浆置换相比,采用DPMAS治疗肝衰竭的临床效果与其相当,均能明显降低TBIL、改善肝脏功能,降低血清炎症表达。
Objective To observe the clinical efficacy of dual plasma molecular adsorption system(DPMAS)and total plasma exchange in patients with liver failure and hyperbilirubinemia.Methods Clinical data of 133 patients with liver failure and hyperbilirubinemia admitted to our hospital from March 2020 to March 2023,who met the inclusion and exclusion criteria,were retrospectively collected.According to the different treatment methods of artificial liver during hospitalization,patients were divided into two groups:group A,with 70 cases treated with DPMAS;group B,63 cases,underwent full plasma exchange.Propensity Score Matching(PSM)was used with a 1∶1 ratio to assign the clinical data of the two groups,and 50 patients in each group were actually paired.Compare the clinical manifestations,liver function,coagulation function,inflammatory indicators,and incidence of adverse reactions during treatment between two groups of patients.Results There was no significant difference in the total effective rate between the two treatment groups(80.00%vs.74.00%)(P>0.05).After treatment,the pre albumin(PA),alpha fetoprotein(AFP),and PA/TB values of the two groups were higher than before treatment,while the total bilirubin(TBIL)was lower than before treatment(P<0.05).However,there was no statistically significant difference in various liver function indicators between the two groups after treatment(P>0.05).After treatment,the prothrombin time(PT)and activated partial thromboplastin time(APTT)were shortened compared to before treatment,while the prothrombin activity(PTA)increased.The international standardized ratio(INR),serum interleukin-6(IL-6),and tumor necrosis factor(TNF)were also measured-α)And a decrease in high-sensitivity C-reactive protein(hs-CRP)(P<0.05).However,there was no significant difference in coagulation indicators and serum inflammation indicators between the two groups after treatment(P>0.05).There was no significant difference in adverse reactions between the two groups after treatment(P>0.05).Conclusion Compared with
作者
李丽
薛婷
卢斌
燕宪亮
许铁
叶英
LILi;XUE Ting;LU Bin;YAN Xianliang;XU Tie;YE Ying(Department of Emergency Medicine,the Affiliated Hospital of Xuzhou Medical University,Xuzhou Jiangsu 221002,China)
出处
《中国急救复苏与灾害医学杂志》
2024年第9期1219-1223,共5页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
江苏省徐州市科技计划项目(编号:KC20144)。
关键词
肝衰竭
高胆红素血症
双重血浆分子吸附系统
血浆置换
临床疗效
Liver failure
Hyperbilirubinemia
Dual plasma molecular adsorption system
Plasma exchange
Clinical efficacy
