中国血液净化

›› 2004, Vol. 3 ›› Issue (4): 211-213.

• 人工肝 • 上一篇    下一篇

人工肝支持系统治疗慢性重型肝炎临床研究

秦 波 郄春花 张大志 赵有蓉 郭树华   

  1. 400010 重庆，重庆医科大学病毒性肝炎研究所
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2004-04-12 发布日期:2004-04-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2004-04-12 Published:2004-04-12

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摘要：

目的 探讨人工肝支持系统（ALSS）治疗慢性重型肝炎的疗效及可能机制。方法 对85例慢性重型肝炎患者随机分为治疗组和对照组，对照组43例患者只给予综合治疗，治疗组42例患者在综合疗法基础上给予ALSS治疗，并分别检测治疗前后肝功能、凝血酶原时间（PT）、肿瘤坏死因子-α（TNF-α）、内毒素及一氧化氮（NO）水平。结果 慢性重型肝炎患者在ALSS治疗后，肝功能明显改善，PT、TNF-α、内毒素及 NO 水平明显下降(P<0.05～0.001)，血清 Cl-水平也明显降低（P<0.001）。ALSS治愈好转率为50.0%（21/42），而对照组治愈好转率为20.9%（9/43），两组疗效比较差异有显著意义（P<0.01）。ALSS不良反应发生率为28.6%（12/42）。结论 ALSS治疗慢性重型肝炎能显著改善患者肝功能，并降低TNF-α、内毒素及NO等病理成分，能明显提高其治愈好转率，其中早、中期患者疗效明显好于晚期患者。

关键词: 人工肝支持系统, 慢性重型肝炎, TNF-α, 内毒素, 一氧化氮

Abstract:

Objective To study the therapentic effect and the possible mechanism of artificial liver support system（ALSS）on patients with chronic severe hepatitis. Methods Forty-two patients with chronic severe hepatitis was treated with artificial liver support system. The liver function, prothrombin time（PT），serum tumor necrosis factor alpha （TNF-α）, endotoxine, nitrogen monoxide（NO）and the side effects were observed. The control group consisted of 43 similar patients treated with the conventional therapy. Results After treating with artificial liver support system, the clinical symptoms of the 42 severe hepatitis pationts were ameliorated. The serum albumin levels increased obviously （P<0.005）. The levels of AST, plasma PT, serum chloridion, total bilirubin, TNFα, endotoxine and NO decreased significantly (P < 0.05 ～ 0.001). Survival rate in the treating group is 50.0% (21/42), while 20.9% (9/43) in the contral group(P < 0.01). The incidence of adverse reaction was 28.6%. Conclusion Artificial liver support system can effectively improve the clinical symptoms and the biochemical indicators, and significantly decrease the levels of pathologic components such as TNF-α, endotoxine and nitrogen monoxide. It can also increase the survival rate, the curative effect of alss was more predominant in earlier patients. Artificial liver support system is an effective and safe treatment of chronic severe hepatitis. 

Key words: Chronic severe hepatitis, TNF-α, Endotoxine, Nitrogen monoxide

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