血浆置换治疗老年性戊型肝炎的生化指标变化分析

目的探讨戊型肝炎患者利用人工肝支持系统血浆置换治疗前后血液生化指标的变化及其临床意义。方法将147例患者分为两组,其中60例为对照组,只进行一般内科治疗,87例为试验组,进行一般内科治疗同时进行人工肝支持系统血浆置换治疗。分别测定两组治疗前后戊肝患者的血液生化指标变化,包括血清丙氨酸氨基移换酶(ALT)、门冬氨酸氨基移换酶(AST)、谷氨酰基移换酶(GGT)、碱性磷酸酶(AKP)、总胆固醇(CHO)、胆碱酯酶(chE)、总胆红素(TBil)、直接胆红素(DBil)、前白蛋白(PA)、血氨(NH3)、总胆汁酸(TBA)、总蛋白(TP)、白蛋白(ALB)、尿素氮(BUN)、肌酐(Cr),并对结果进行分析和统计学处理。结果试验组人工肝支持系统血浆置换治疗后ALT、AST、ALP、GGT、TBil、DBil、TBA和NH3明显降低,各指标前后差值与对照组差值比较有统计学差异(P<0.01,P<0.05);PA,TP、ALB,chE和CHO明显升高,与对照组比较有统计学差异(P<0.01,P<0.05);而BUN、Cr无明显变化,与对照组比较无统计学差异(P>0.05)。结论人工肝支持系统血浆置换后肝脏功能明显改善,是临床治疗戊型肝炎安全而有效措施之一,值得推广,特别是对老年戊型肝炎患者的肝细胞再生赢得时间。

Analysis of the changes of blood biochemical indicators before and after plasma exchange in the treatment of Senile hepatitis E

Objective To explore the change of the treatment of Senile hepatitis E patients with artificial liver support of plasma exchange. Methods 147 cases of patients were randomly divided into two groups. The control group was 60 cases; The treatment group was 87cases.Measured the blood biochemical indicators of the 87 cases of Senile hepatitis E patients before and after the treatment by artificial liver support of plasma exchange, include ALT, AST, GGT, AKP, CHO, chE, TBil, DBil, PA, NH3, TBA, TP, ALB, BUN and Cr, and then analyzed the results with statistical processing. Results The treatment group was better than the control group. There was statistical significance（P〈0.05） After treated by artificial liver support system of plasma exchange, ALT, AST, ALP, GGT, TBil, DBil, TBA and NH3 decreased significantly. Compared with before treated, P〈0.01 or P〈0.05. PA,TP, ALB, chE and CHO rised significantly. Compared with before treated, P〈0.01 or P〈0.05. But BUN and Cr had no obvious changed. Compared with before treated, P〉0.05. Conclusions After artificial liver support of plasma exchange, liver function improve markedly. It is one of the safe and effective measures of hepatitis E in Clinical treatment. Especially to win time for the regeneration of liver cells in elderly patients with hepatitis E.