中国血液净化

中国血液净化 ›› 2020, Vol. 19 ›› Issue (10): 649-652.doi: 10.3969/j.issn.1671-4091.2020.09.001

• 临床研究 •    下一篇

双重血浆分子吸附系统治疗高胆红素血症的疗效分析

孙玉霞1,雷鸣1,许开亮1,游丽娇1,袁维方1   

  1. 1上海中医药大学附属第七人民医院重症医学科
  • 收稿日期:2020-03-10 修回日期:2020-07-20 出版日期:2020-10-12 发布日期:2020-10-12
  • 通讯作者: 袁维方 yuanjinzhen31@163.com E-mail:yuanjinzhen31@163.com
  • 基金资助:
    国家自然科学基金面上项目(81973649)；浦东新区卫生系统领先人才培养计划(PWR12019-02)；七院新星(XX2019-008)

Efficacy analysis of double plasma molecular adsorption system in the treatment of hyperbilirubinemia

  1.  1Department of Critical Care Medicine, Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai 200137, China
  • Received:2020-03-10 Revised:2020-07-20 Online:2020-10-12 Published:2020-10-12

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摘要： 【摘要】目的  观察高胆红素血症患者行双重血浆分子吸附系统治疗的临床疗效，探讨最佳的吸附血浆量。方法  回顾性分析于上海中医药大学附属第七人民医院行双重血浆分子吸附系统治疗的18 例高胆红素血症患者，以单次治疗的血浆吸附量作为治疗剂量分层，统计分析和比较治疗前后患者的血常规、凝血及肝肾功能。结果  18 例患者共行24 次双重血浆分子吸附系统治疗，其中显效2例，有效15例，无效1例，总有效率为94.44%。治疗后患者血清总胆红素、直接胆红素、血小板计数、血浆纤维蛋白原降低(t值分别为16.424, 4.324, 5.124, 2.237；P值分别为＜0.001, 0.001, ＜0.001, 0.039)，C-反应蛋白下降(t=3.519, P=0.003)，凝血酶原时间延长(t=0.245，P=0.041)。单次血浆吸附总量以正常人体血浆量倍数分层(正常人体血浆容量按4000ml 计算，分组为1.5～2.5 倍、2.5～3.5 倍、3.5～4.5 倍、4.5～5.5倍、5.5～6.5 倍)后，结果显示(2.5～3.5 倍人体血浆量)组患者的总胆红素下降率高于(1.5～2.5 倍)组(t=-2.633，P=0.017)，其余各组间比较无统计学意义(P＞0.05)。结论双重血浆分子吸附系统治疗高胆红素血症患者的疗效显著，单次血浆吸附总量为2.5～3.5 倍人体血浆量显示出更好的疗效趋势。

关键词: 双重血浆分子吸附系统, 胆红素, 吸附, 疗效

Abstract: 【Abstract】Objective To observe the clinical effects of double plasma molecular adsorption system in the treatment of hyperbilirubinemia patients and to investigate the optimal adsorbed plasma volume. Methods A retrospective analysis was performed for the 18 patients with hyperbilirubinemia treated with double plasma molecular adsorption system in the Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine. Patients were grouped according to the total plasma adsorption volume in a single treatment. Their laboratory indicators including blood routine, coagulation function, and liver and kidney functions before and after the treatment were analyzed. Results A total of 24 times of double plasma molecular adsorption
systems were used in the 18 patients, of which 2 cases were markedly effective, 15 cases were effective, and one case was ineffective, with a total effective rate of 94.44%. After the treatment, serum total bilirubin (t=16.424, P＜0.001), direct bilirubin (t=4.324, P＜0.001), platelet count (t=5.124, P＜0.001) plasma fibrinogen (t=2. 237, P=0.039) and C-reactive protein (t=3.519, P=0.003) decreased, and prothrombin time increased (t=0.245, P=0.041). The ratio of total adsorbed plasma volume in a single treatment to total plasma volume in normal individuals (4000 ml) was used to divide the patients into 5 groups: 1.5～2.5 times, 2.5～3.5 times, 3.5～4.5 times, 4.5～5.5 times and 5.5～6.5 times groups. The rate of the total bilirubin reduction was higher in 2.5～3.5 times group than in 1.5～2.5 times group (t=-2.633, P=0.017), but had no significant differences among other groups (P＞0.05). Conclusion The double plasma molecular adsorption system was effective in treating hyperbilirubinemia. The total adsorbed plasma volume in a single treatment in the range of 2.5 to 3.5 times of total plasma volume will have a better therapeutic effect.

Key words: Double plasma molecular adsorption system, Bilirubin, Adsorb, Therapeutic effect

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