中华生物医学工程杂志
中華生物醫學工程雜誌
중화생물의학공정잡지
CHINESE JOURNAL OF BIOMEDICAL ENGINEERING
2008年
1期
59-62
,共4页
血浆置换%肝炎,乙型%连续白蛋白净化%连续性血浆滤过吸附
血漿置換%肝炎,乙型%連續白蛋白淨化%連續性血漿濾過吸附
혈장치환%간염,을형%련속백단백정화%련속성혈장려과흡부
Plasma exchange%HepatitisB%Continuous albuminpurification%Continuous plasma filtration absorption
目的 探讨血浆置换(PE)联合连续白蛋白净化系统(CAPS)或连续性血浆滤过吸附(CPFA)治疗中、晚期重型乙型肝炎临床疗效.方法44例重型乙型肝炎患者随机分为PE+CAPS组、PE+CPFA组与对照组,前两组在内科保守治疗基础上予PE+CAPS或PE+CPFA治疗,对照组仅给予内科保守治疗.比较3组临床效果及总存活率.结果 PE+CAPS组及PE+CPFA组单次治疗后血总胆红素(TBil)较治疗前分别下降42.82%和35.53%.丙氨酸转氨酶(ALT)在PE+CAPS组由(169.5±142.7)U/L降至(73.4±49.8)U/L;在PE+CPFA组由(181.3±76.7)U/L降至(95.4±523)U/L.胆汁酸(TBA)在PE+CAPS组由(122.9±49.3) μmol/L降至(64.0±30.3) μmol/L;在PE+CPFA组由(119.9±52.7) μmol/L降至(9.9±28.4)μmol/L.上述差异均有统计学意义(P值均＜0.01).治疗前后白蛋白、电解质均无显著改变.CAPS治疗后血尿素氮(BUN)、肌酐(Scr)、血氨均显著下降(P＜0.01).PE+CAPS组总存活百分比为61.5%,PE+CPFA组为53.3%,均较对照组总存活百分比(25.0%)显著提高.结论 PE+CAPS及PE+CPFA是治疗中、晚期重型乙型肝炎安全而有效的方法 ,能明显提高患者存活百分比.
目的 探討血漿置換(PE)聯閤連續白蛋白淨化繫統(CAPS)或連續性血漿濾過吸附(CPFA)治療中、晚期重型乙型肝炎臨床療效.方法44例重型乙型肝炎患者隨機分為PE+CAPS組、PE+CPFA組與對照組,前兩組在內科保守治療基礎上予PE+CAPS或PE+CPFA治療,對照組僅給予內科保守治療.比較3組臨床效果及總存活率.結果 PE+CAPS組及PE+CPFA組單次治療後血總膽紅素(TBil)較治療前分彆下降42.82%和35.53%.丙氨痠轉氨酶(ALT)在PE+CAPS組由(169.5±142.7)U/L降至(73.4±49.8)U/L;在PE+CPFA組由(181.3±76.7)U/L降至(95.4±523)U/L.膽汁痠(TBA)在PE+CAPS組由(122.9±49.3) μmol/L降至(64.0±30.3) μmol/L;在PE+CPFA組由(119.9±52.7) μmol/L降至(9.9±28.4)μmol/L.上述差異均有統計學意義(P值均＜0.01).治療前後白蛋白、電解質均無顯著改變.CAPS治療後血尿素氮(BUN)、肌酐(Scr)、血氨均顯著下降(P＜0.01).PE+CAPS組總存活百分比為61.5%,PE+CPFA組為53.3%,均較對照組總存活百分比(25.0%)顯著提高.結論 PE+CAPS及PE+CPFA是治療中、晚期重型乙型肝炎安全而有效的方法 ,能明顯提高患者存活百分比.
목적 탐토혈장치환(PE)연합련속백단백정화계통(CAPS)혹련속성혈장려과흡부(CPFA)치료중、만기중형을형간염림상료효.방법44례중형을형간염환자수궤분위PE+CAPS조、PE+CPFA조여대조조,전량조재내과보수치료기출상여PE+CAPS혹PE+CPFA치료,대조조부급여내과보수치료.비교3조림상효과급총존활솔.결과 PE+CAPS조급PE+CPFA조단차치료후혈총담홍소(TBil)교치료전분별하강42.82%화35.53%.병안산전안매(ALT)재PE+CAPS조유(169.5±142.7)U/L강지(73.4±49.8)U/L;재PE+CPFA조유(181.3±76.7)U/L강지(95.4±523)U/L.담즙산(TBA)재PE+CAPS조유(122.9±49.3) μmol/L강지(64.0±30.3) μmol/L;재PE+CPFA조유(119.9±52.7) μmol/L강지(9.9±28.4)μmol/L.상술차이균유통계학의의(P치균＜0.01).치료전후백단백、전해질균무현저개변.CAPS치료후혈뇨소담(BUN)、기항(Scr)、혈안균현저하강(P＜0.01).PE+CAPS조총존활백분비위61.5%,PE+CPFA조위53.3%,균교대조조총존활백분비(25.0%)현저제고.결론 PE+CAPS급PE+CPFA시치료중、만기중형을형간염안전이유효적방법 ,능명현제고환자존활백분비.
Objective To evaluate the clinical efficacy of plasma exchange (PE) combined with continuous albumin purification system (CAPS) or continuous plasma filtration absorption (CPFA) in the treatment of patients with severe hepatitis B in middle and late stage. Methods Forty-four patients with severe hepatitis B were randomly divided into PE+CAPS group,PE+CPFA group and control group.Basing on conservative therapy,two groups underwent PE+CAPS or PE+CPFA respectively. Efficacy and total survival rate in above different groups were investigated.Results After a single treatment in PE+CAPS and PE+CPFA groups,total serum bilirubin decreased obviously by 40.82% and 35.53%. Alanine aminotransferase was decreased from (169.5±142.7) U/L to (73.4±49.8) U/L in PE+CAPS group,from (181.3±76.7) U/L to (95.4 ±52.3) U/L in PE+CPFA group. Bile acid was decreased from (122.9±49.3) μmol/L to (64.0±30.3) μmol/L in PE+CAPS group,while from (119.9±52.7) μmol/L to (9.9±28.4) μmol/L in PE+CPFA group (P＜0.01). No significant difference was found in albumin and electrolure (P＞0.05). Nitrogen,creatinine and ammonia decreased after CAPS (P＜0.01). The total survival rate was 61.5% in PE+CAPS group,and 53.3% in PE+CPFA group,which was significantly higher than 25.00% in control group. Conclusions The regimens of PE combined with CAPS or CPFA are safe and effective for patients with severe hepatitis B in middle and late stage with the improvement of survival rate.
