血浆置换治疗慢性重型肝炎疗效影响单因素分析

目的探讨血浆置换(plasma exchange,PE)治疗对慢性重型肝炎疗效的影响因素。方法对109例慢性重型肝炎患者在内科综合治疗基础上进行PE治疗,用SPSS软件分析治疗次数、年龄、发病基础、并发症、生化指标等各因素对PE治疗慢性重型肝炎疗效的影响。结果治愈好转67例,有效率61.47%;PE的次数以3次为宜,随着次数增加,疗效无明显提高;年龄越大,疗效越差;早期、中期有效率明显高于晚期(P<0.01);在肝硬化基础上发生重型肝炎者有效率只有41.38%,低于携带者和慢性肝炎基础上发生重肝者(P<0.05);治疗前并发症越多,疗效越差;血清总胆红素(TBIL)升高、总胆固醇(TC)、胆碱酯酶活力(CHE)及凝血酶原活动度(PTA)下降的程度与PE的疗效有关(P<0.05)。结论PE为重型肝炎治疗提供了有效的手段,大大提高了疗效,但应把握治疗时机和治疗次数,及早治疗,严密观察病情变化,使病人得到及时救治。

Single Factor Analysis on Efficacy of Plasma Exchange (PE) for Chronic Severe Hepatitis

Objective To explore the prognosis factors of plasma exchange(PE) for the treatment of chronic severe hepatitis.Methods 109 patients with chronic severe hepatitis were reated with PE except for basic medical therapy.The factors such as times of treatment,age,basic disease,complication and the biochemical indeces of efficacy of the patients with chronic severe hepatitis using PE were analysed using SPSS software Results 67 patients improved and cured(61.47%).3 times are optimal for PE treatment.There is no remarkably increasing efficacy was observed with more times of PE.The more older,the lower efficacy is;the study also approved that the efficacy of early stage and middle stage groups are both higher than that of late stage group(P<0.05);the efficacy for severe hepatitis on liver cirrhosis patients is only 41.38%,which is lower than that of severe hepatitis on both chronic carrier and chronic hepatitis ones(P<0.05);the more complication before treatment exist,the worse efficacy is;increasing of the total bilirubin(TBIL) and decreasing of total cholesterol(TC),cholinesterase(CHE),and prothrombin time activity(PTA) were associated with the efficacy of PE(P<0.05).Conclusions PE not only provide a effective therapeutic measure for severe hepatitis,but also increase their livability.