分子吸附再循环系统治疗急慢性肝功能衰竭的临床研究

目的 总结用分子吸附再循环系统(moleclular adsorbent recirculating system, MARS)治疗各类原因所致肝功能衰竭患者的经验。方法 回顾并随访分析25例次MARS人工肝治疗的疗效。结果 单次6h MARS治疗显著降低患者血清总胆红素(618.51±200.68)mmol/L到(390.81±146.02)mmol/L, t=2.729,P＜O.01]、间接胆红素(490.03±163.39)mmol/L到(303.28±113.06)mmol/L,t=2.516,P＜0.01]和血氨(152.44±82.62)mmol/L到(84.84±13.30)mmol/L,t=2.174, P＜0.05] 水平;升高凝血酶原活动度(70.55±32.39到93.63±14.20,t=1.728,P＜0.05)。肝功能酶谱、血清蛋白质、肾功能、电解质、血常规和血气分析指标无显著变化。17例患者,治愈和好转13例,死亡4例,存活率76.5%。结论MARS人工肝是治疗肝功能衰竭患者安全、有效的辅助方法。

Clinical research of patients with acute or chronic hepatic failure treated with molecular adsorbent recirculating system

OBJECTIVE: To summarize the experience of a single treatment using molecular adsorbent recirculating system (MARS) in patients with acute-on-chronic liver failure. METHODS: Twenty-five eases treated by MARS-artificial liver were followed up and reviewed. RESULTS: The levels of serum total bilirubin, non-conjugated bilirubin and blood ammonia were significantly decreased from (618.51 200.68) mmol/L to (390.81 146.02) mmol/L (t=2.729, P<0.01), (490.03 163.39) mmol/L to (303.28 113.06) mmol/L (t =2.516, P<0.01), and (152.44 82.62)mmol/L to (84.80 13.30)mmol/L (t=2.174, P<0.05), respectively. Prothrombin activity was significantly increased from 70.55% 32.39% to 93.63% 14.20% (t=1.728, P<0.05) in patients during a single 6 h treatment with MARS. No difference was presented in the markers of liver zymogram, serum protein, kidney function, electrolyte, blood routine and blood gas analysis before and after the MARS. Thirteen of 17 patients have been cured or improved, 4 died, and the survival rate was 76.5%. CONCLUSIONS: MARS is a safe and an effective treatment for patients with liver failure.