人工肝支持系统在重型肝炎中的临床应用

目的探讨人工肝支持系统（AISS）治疗重型肝炎的临床疗效和安全性。方法对69例重型肝炎患者在内科综合治疗的同时给予ALSS治疗，每例治疗1—8次，平均4．4次，间隔2～3d，观察治疗前后临床表现，监测治疗前后主要实验室检查指标，并比较重型肝炎不同类型及时期应用ALSS的治疗效果。结果69例患者血常规、内毒素及NO水平明显下降，凝血酶原活性、白蛋白升高。急性、慢性重型肝炎治愈好转患者分别为7例（58．3％）、11例（25．0％），慢性重型肝炎早、中、晚期治疗治愈好转患者分别为17例（70．8％）、7例（38．9％）、0例。结论AISS治疗急性重型肝炎的治疗效果较好，慢性重型肝炎在早、中期治疗最为适宜，并能降低肿瘤坏死因子（TNF-α）、内毒素及NO等病理成分，从而减轻重型肝炎时免疫反应对肝细胞的损伤，能明显提高其生存率。ALSS治疗后肝功生化监测和临床表现能提示预后。

Artificial liver support system in treatment of viral hepatitis gravis

Objective To study the efficacy and safety of artificial liver support system(ALSS) in the treat-ment of hepatitis gravis. Methods Sixty-nine patients suffering from hepatitis gravis were treated with internal com-bined therapy as well as ALSS. Clinical manifestation and laboratory examination index were examined before and af-ter ALSS therapy. Moreover, the efficacy of ALSS treatment in the different stages of hepatitis gravis was investiga-ted. Results There was significant decrease of endotoxin concentration and NO level after therapy of ALSS, while PTA and ALB increased. The response rates of hepatitis gravis in early stage, middle stage and late stage were 70. 8%, 38.9% and 0 respectively. Conclusion The ALSS is effective in treating hepatitis gravis, especially in acute hepatitis gravis and in early and middle stages of chronic hepatitis gravis patients It can decrease TNF-α,endotoxin concentration and NO level and relieve liver cell injury of hepatitis gravis and improve survival rate.