| 王 眉,党 璇,党 娥,杜 丹,王晓莹.血浆置换联合血液灌流胆红素吸附对慢性重型乙型病毒性肝炎患者血清生化指标的影响[J].,2021,(9):1719-1723 |
| 血浆置换联合血液灌流胆红素吸附对慢性重型乙型病毒性肝炎患者血清生化指标的影响 |
| Effect of Plasma Exchange Combined with Hemoperfusion Bilirubin Adsorption on Serum Biochemical Indexes in Patients with Chronic Severe Hepatitis B |
| 投稿时间：2020-08-25 修订日期：2020-09-20 |
| DOI：10.13241/j.cnki.pmb.2021.09.026 |
| 中文关键词: 血浆置换 血液灌流胆红素吸附 慢性重型乙型病毒性肝炎 血清生化指标 |
| 英文关键词: Plasma exchange Blood perfusion bilirubin adsorption Chronic severe hepatitis B Serum biochemical indicators |
| 基金项目:陕西省自然科学基础研究计划项目(2016JZ7529) |
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| 中文摘要: |
| 摘要 目的：探讨血浆置换联合血液灌流胆红素吸附对慢性重型乙型病毒性肝炎患者血清生化指标的影响。方法：选取研究对象为我院2018年5月~2019年5月收治的80例慢性重型乙型病毒性肝炎患者，采用随机数表法分为对照组（给予血浆置换术治疗）和研究组（给予血浆置换联合血液灌流胆红素吸附治疗）各40例，观察两组治疗前后血清生化指标包括肝功能指标[血清谷草转氨酶（serum aspartate aminotransferase，GOT）、谷丙转氨酶（alanine aminotransferase，GPT）、总胆汁酸（total bile acid，TBA）、天冬氨酸氨基转移酶（Aspartate aminotransferase，AST）、丙氨酸转氨酶（alanine aminotransferase，ALT）、血浆白蛋白（plasma albumin，Alb）、总胆红素（total bilirubin，TBiL）及球蛋白（globulin，GLO）]、血清炎性因子[肿瘤坏死因子-α（tumor necrosis factor- α，TNF-α）、白细胞介素-6（interleukin-6，IL-6）、IL-18、IL-8、IL-10]、T细胞亚群[CD4+、CD8+]及HBV-DNA载量。统计两组治疗后血浆用量及治疗时间、临床疗效及不良反应发生改善情况。结果：治疗后，研究组治疗效果明显优于对照组（92.5 % vs 72.5 %，P＜0.05）；两组TBA、AST、ALT、TBiL、GLO、TNF-α、IL-6、IL-18及IL-8水平，CD8+含量及HBV-DNA载量均有所下降，而Alb、IL-10水平及CD4+含量均上升（P＜0.05），其中研究组上述指标的变化优于对照组（P＜0.05）。在治疗过程中，研究组血浆用量明显低于对照组（P＜0.05）；两组治疗时间比较无差异（P＞0.05）。研究组不良反应发生率显著低于对照组（7.50 % vs. 27.50 %，P＜0.05）。结论：血浆置换联合血液灌流胆红素吸附在慢性重型乙型病毒性肝炎患者效果明显优于与血浆置换，可调节血清生化指标，安全性高。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of plasma exchange combined with blood perfusion bilirubin adsorption on serum biochemical indexes in patients with chronic severe hepatitis B. Methods: The research subjects were 80 patients with chronic severe hepatitis B, who were admitted to First Affiliated Hospital of Air Force Military Medical University from May 2018 to May 2019, and they were randomly divided into control group (n=40, given plasma exchange therapy) and research group (n=40, plasma exchange combined with blood perfusion bilirubin adsorption treatment). The serum biochemical indicators of the two groups of patients before and after treatment were observed, including liver function indicators (GOT, GPT, TBA, AST, ALT, Alb, TBiL and GLO), serum inflammatory factors (TNF-α, IL-6, IL-18, IL-8, IL-10), T cell subsets [CD4+, CD8+] and HBV-DNA load. The plasma dosage and treatment time, clinical efficacy and improvement of adverse reactions after treatment were statistically analysed in the two groups. Results: After treatment, the treatment effect of the study group was significantly better than that of the control group (92.5 % vs 72.5 %, P<0.05). The levels of TBA, AST, ALT, TBiL, GLO, TNF-α, IL-6, IL-18 and IL-8, CD8+ content and HBV-DNA load in the two groups decreased, while the levels of Alb, IL-10 and the content of CD4+ increased (P＜0.05), and the above indicators in the study group were better than those in the control group (P＜0.05). During the treatment process, the plasma consumption of the study group was significantly lower than that of the control group (P<0.05). There was no difference in the treatment time between the two groups (P>0.05). The incidence of adverse reactions in the study group was significantly lower than that in the control group (7.50 % vs 27.50 %, P<0.05). Conclusion: The effect of plasma exchange combined with blood perfusion bilirubin adsorption in the patients with chronic severe hepatitis B was significantly better than plasma exchange, which can adjust serum biochemical indexes, with high safety. |
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