MELD在评价血浆置换治疗重型肝炎疗效中的作用

目的应用终末期肝病评分模型评价血浆置换治疗重型肝炎的临床疗效。方法 62例重型肝炎患者在内科综合治疗基础上联合血浆置换治疗,分析血浆置换治疗前后实验室指标的变化,并随访所有患者3个月内的临床转归。结果血浆置换治疗明显降低胆红素、胆汁酸、丙氨酸氨基转移酶水平;血浆置换治疗后患者3个月实际病死率是56.5%,显著低于预期病死率75.8%(P0.05),尤其在MELD30分的患者中疗效显著。而对于MELD≥30分组血浆置换治疗并不能改善预后。结论血浆置换是治疗重型肝炎的有效、安全的肝脏支持装置,对MELD30分以下者能显著改善预后。

The curative effect of plasma exchange on patients with severe hepatitis

Objective To evaluate the curative effect of plasma exchange in the treatment of severe hepatitis by the model for end-stage liver disease. Method 62 patients with severe hepatitis were treated with plasma exchange. Blood chemical data were collected pre-treatment and post-treatment. All of the patients graded with MELD and the fatality rate were observed three months later. Results The concentration of TBil,TBA,ALT in the sera were much lower than post-treatment （P〈0.05）;After plasma exchange treatment,overall death rate of 62 patients was 56.5%,much less than the prediction of mortality （76.3%,P〈0.05）,especially in the group of patients with MELD score less than 30. Conclusion As a hepatic support device,plasma exchange is a useful way for therapy of severe hepatitis.