CAJ | 학술논문

目的：通过观察人工肝支持系统对肝衰竭患者血清超敏 C 反应蛋白（hs -CRP）水平的影响，探讨 hs -CRP 水平改变对肝衰竭临床转归的影响。方法选取2011年11月-2013年12月在武汉市第七医院住院的患者134例，分为3组。分别测定经人工肝支持系统治疗的肝衰竭患者（n ＝60）及未行人工肝支持系统治疗的肝衰竭患者（n ＝37）治疗前后以及慢性乙型肝炎（CHB）患者（n ＝37）血清 hs -CRP 水平，并对结果进行统计分析。计量资料组间比较采用 t 检验，计数资料采用卡方检验。结果3组患者治疗前均检测了 hs -CRP 的水平分别为（12．89±9．39）、（12．22±9．73）、（2．83±6．79）mg/L。人工肝治疗组与未行人工肝治疗组比较，差异无统计学意义（P 值均＞0．05）；肝衰竭两组与 CHB 组比较，差异均有统计学意义（P 值均＜0．001）。人工肝治疗组临床好转率为78．33％，与未行人工肝治疗组临床好转率54．05％相比，差异有统计学意义（χ2＝6．315，P ＜0．05）；人工肝治疗有效组患者治疗后血清 hs -CRP 明显下降（t ＝5．344，P ＝0.000），与人工肝治疗无效组治疗后相比，差异有统计学意义（t ＝2．368，P ＝0.038）。结论人工肝支持系统治疗能降低肝衰竭患者血清 hs -CRP 的水平，观察 hs -CRP 水平的变化对病情的进展及人工肝的疗效有很好的指导作用。
목적：통과관찰인공간지지계통대간쇠갈환자혈청초민 C 반응단백（hs -CRP）수평적영향，탐토 hs -CRP 수평개변대간쇠갈림상전귀적영향。방법선취2011년11월-2013년12월재무한시제칠의원주원적환자134례，분위3조。분별측정경인공간지지계통치료적간쇠갈환자（n ＝60）급미행인공간지지계통치료적간쇠갈환자（n ＝37）치료전후이급만성을형간염（CHB）환자（n ＝37）혈청 hs -CRP 수평，병대결과진행통계분석。계량자료조간비교채용 t 검험，계수자료채용잡방검험。결과3조환자치료전균검측료 hs -CRP 적수평분별위（12．89±9．39）、（12．22±9．73）、（2．83±6．79）mg/L。인공간치료조여미행인공간치료조비교，차이무통계학의의（P 치균＞0．05）；간쇠갈량조여 CHB 조비교，차이균유통계학의의（P 치균＜0．001）。인공간치료조림상호전솔위78．33％，여미행인공간치료조림상호전솔54．05％상비，차이유통계학의의（χ2＝6．315，P ＜0．05）；인공간치료유효조환자치료후혈청 hs -CRP 명현하강（t ＝5．344，P ＝0.000），여인공간치료무효조치료후상비，차이유통계학의의（t ＝2．368，P ＝0.038）。결론인공간지지계통치료능강저간쇠갈환자혈청 hs -CRP 적수평，관찰 hs -CRP 수평적변화대병정적진전급인공간적료효유흔호적지도작용。
Objective To evaluate the clinical effect of artificial liver support system (ALSS)on serum high -sensitivity C -reactive pro-tein (hs -CRP)level and investigate the influence of the change in hs -CRP level on clinical prognosis among patients with hepatic failure. Methods Patients were recruited into three groups:group one included 60 patients who received ALSS due to hepatic failure;group two in-cluded 37 patients with hepatic failure without ALSS treatment;and group three included 37 patients with chronic hepatitis B.The serum levels of hs -CRP were measured in groups two and three,and in group one before and after ALSS treatment.Comparison of continuous data between groups was made by t test,and comparison of categorical data was made by chi -square test.Results The levels of hs -CRP in group one before treatment and in groups two and three were 12.89 ±9.39,12.22 ±9.73,and 2.83 ±6.79,respectively.No significant difference in hs -CRP level between group one and group two was observed (P >0.05).However,the hs -CRP level in group three was significantly different from those in group one and group two (P <0.001 ).The improvement rate in group one after ALSS treatment (78.3%)was significantly higher compared with that in group two (54.05%)(χ2 =6.315,P <0.05).ALSS treatment (t =5.179,P <0.05).ALSS treatment was selectively effective in a subgroup of patients and greatly decreased the hs -CRP level in these patients (t =5.344,P =0.000),resulting in a significant difference from the patients who were unresponsive to ALSS treatment (t =2.368,P =0.038).Conclusion Artificial liver support system can decrease the hs -CRP level in patients with hepatic failure.Serum level of hs -CRP can be used as a clinical indicator of disease progression and predict the clinical outcomes of ALSS in patients with hepatic failure.