人工肝支持系统治疗重型肝炎应用研究

目的　为进一步探索人工肝支持系统（ＡＬＳＳ） 治疗重型肝炎临床应用疗效，并研究其机制。方法　对８８ 例重型肝炎患者应用ＡＬＳＳ 治疗，并检测治疗前、后肝功能，内毒素含量等，并对部分患者检测血清乙型肝炎病毒（ＨＢＶ） 含量、氨基酸谱等。比较重型肝炎不同期应用ＡＬＳＳ治疗效果。结果　ＡＬＳＳ治疗后，重型肝炎患者肝功能明显改善，血内毒素由治疗前（６２ ．４１ ±２８ ．１８）ｎｇ／Ｌ降至治疗后（４３ ．５６ ±２２ ．１５）ｎｇ／Ｌ（ Ｐ＜ ０ ．００１） ，ＨＢＶ 量由（２ ５８８ ±１ ５３４）ｃｏｐｉｅｓ／ｍｌ 降至（１ ８１５ ±６２０）ｃｏｐｉｅｓ／ｍｌ（ Ｐ＜ ０ ．０５） 。蛋氨酸和芳香族氨基酸浓度下降，ＢＣＡＡ／ＡＡＡ 比值由１ ．１８ 上升至１ ．５２（ Ｐ＜ ０ ．０５） 。早、中、晚期重型肝炎应用ＡＬＳＳ治疗治愈好转率分别为９０ ．９ ％ 、７１ ．０ ％ 、２０ ．５ ％ 。结论　ＡＬＳＳ治疗重型肝炎疗效可靠，在早、中期治疗最为适宜。

Use of artificial liver support system in the treatment of viral hepatitis gravis

Objective In order to study the efficacy as well as the mechanism of artificial liver support system(ALSS)in the treatment of hepatitis gravis.Methods 88 patients suffering from hepatitis gravis were treated with ALSS.The liver function and endotoxin level before and after ALSS therapy were examined,and the serum HBV concentration and amino acids spectrum in some patients were also detected.Moreover,the efficacy of ALSS treatment in the different stages of hepatitis gravis was investigated.Results It showed that liver function was significantly improved after ALSS therapy.There were significant decreases of endotoxin concentrationfrom(62.41±28.18)ng/L to(43.56±22.15)ng/L,P＜0.001]and HBV concentration from(2 588±1 534)eopies/ml to(1 815±620)copies/ml,P＜0.05.Aromatic amino acid(AAA)such as methionine concentration was reduced and BCAA/AAA ratio was increased from 1.18 to 1.52(P＜0.05).The response rates of hepatitis gravis in early stage,middle stage and late stage were 90.9%.71.0%and 20.5%.respectively.Conclusion The ALSS is effective in treating hepatitis gravis,especialy in early and middle stages.