不同血液净化模式对高胆红素血症的治疗效果比较

目的 非生物人工肝主要通过血浆置换和胆红素吸附达到暂时改善肝功能的目的,本研究旨在了解不同血液净化模式对高胆红素血症的治疗效果.方法 对6例高胆红素血症患者进行了选择性血浆置换(SPE)、胆红素吸附(PA)及选择性血浆置换加胆红素吸附(SPE+PA)治疗,比较治疗前后总胆红素(TB)和直接胆红素(DB)的下降幅度和清除率.结果 三种治疗模式治疗前后比较,TB和DB水平均显著下降(P＜0.05).TB和DB的清除率以(SPE+ PA)组最大,分别为(37.8±3.9)％和(38.0±3.4)％,与SPE组比为显著差异(P＜0.001).PA组与(SPE+ PA)组比较,TB的清除率均无显著差异(P＞0.05).结论 单纯使用国产胆红素吸附柱(BS330-Ⅱ)治疗可有效降低患者的胆红素水平,联合SPE+ PA治疗,疗效增加不显著.

The treatment effects of different blood purification models in the patients with hyperbilirubinemia

Objectives To compare the treatment effects of different blood purification model in the patients with hyperbilirubinemia.Methods Three blood purifications, selected plasma exchange (SPE), plasmaadsorption (PA) with bilirubin adsorption column and combination use of SPA and PA, were performed in 6 patients with hyperbilirubinemia.The levels of total bilirubin (TB) and direct bilirubin (DB) were tested before and after treatment, and the decrease range and clearance rate were calculated.Results In the three blood purifications models, compared between before and after treatment, the levels of TB and DB were decrease significantly, P ＜ 0.05.But the highest clearance rates of TB and DB were (37.8 ± 3.9)％ and (38.0 ± 3.4)％ in the combination use of SPA and PA group and were significantly higher than SPE group(P ＜0.001), respectively.In the PA group, the clearance rates of DB was no significant difference compared with SPE + PA group (P ＞ 0.05).Conclusions Plasma adsorption with domestic-made bilirubin adsorption column BS330-Ⅱ was effective to decrease the levels of TB and DB in the patients with hyperbilirubinemia, and combination with SPE did not increase the effect significantly.