人工肝支持系统对肝衰竭患者血清超敏C反应蛋白水平的影响

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,P0.05);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。

Clinical effect of artificial liver support system on serum hs -CRP level in patients with hepatic failure

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.