血浆置换治疗慢性乙型重型肝炎42例临床分析

目的:分析血浆置换治疗慢性乙型重型肝炎的效果。方法:收集从2007年1月至2011年6月在我科住院的42例慢性乙型重型肝炎患者,在内科综合治疗的基础上加用血浆置换治疗,治疗前、治疗后分别采取外周静脉血检测肝功能和凝血酶原时间。结果:42例慢性乙型重型肝炎患者在血浆置换治疗后外周血谷丙转氨酶(271.41±92.83)U/L、谷草转氨酶(291.51±85.72)U/L、总胆红素(178.13±40.13)umol/L、直接胆红素(97.38±27.66)umol/L、间接胆红素(80.76±18.89)umol/L、凝血酶原时间(15.20±1.80)s均较治疗前[分别为(374.94±127.10)umol/L,(361.67±112.89)umol/L,(453.13±69.22)umol/L,(252.65±46.32)umol/L,(200.48±35.98)umol/L,(26.17±2.62)s]显著下降(p<0.01),不良反应发生率为15.5%。结论:血浆置换能改善慢性乙型重型肝炎的肝功能,是治疗慢性乙型重型肝炎的有效方法。

Clinical Analysis of Plasma Exchange Therapy in 42 Patients with Chronic Severe Hepatitis B

Objective:To analyze the therapeutic effect of plasma exchange in the treatment of patients with chronic severe hepatitis B.Methods:Forty two hospitalized patients with chronic severe hepatitis B received plasma exchange therapy in addition to internal comprehensive therapy in our department from January 2007 to June 2011.The liver function and prothrombin time(PT) were examined in all patients before and immediately after plasma exchange.Results:After the plasma exchange,the levels of serum alanine aminotransferase,aspartate aminotransferase,total bilirubin,direct bilirubin,and indirect bilirubin,PT(271.41 ± 92.83)U/L,(291.51 ± 85.72)U/L,(178.13 ± 40.13)umol/L,(97.38 ± 27.66)umol/L,(80.76 ± 18.89)umol/L,(15.20 ± 1.80)s,respectively) were decreased significantly(all p < 0.01),as compared to those before plasma exchange [(374.94 ± 127.10)umol/L,(361.767 ± 112.89)umol/L,(453.13 ± 69.22)umol/L,(252.65 ± 46.32)umol/L,(200.48 ± 35.98)umol/L,(26.17 ± 2.62)s,respectively].The adverse reaction rate was 15.5 %.Conclusion:The plasma exchange can improve the liver function of patients with chronic severe hepatitis B and is an effective therapy for chronic severe hepatitis B.