血浆置换对重型肝炎患者肝纤维化指标的影响

目的探讨血浆置换对重型肝炎患者肝功能肝纤维化指标的影响及临床疗效。方法将绍兴市第六人民医院收治的66例重型肝炎患者随机分为2组：对照组30例，给予常规内科治疗；治疗组36例，在对照组治疗基础上加人工肝血浆置换术；观察两组患者治疗前后肝功能及肝纤维化指标的变化情况。结果两组治疗后ALT、TBil、层黏连蛋白（LN）及Ⅲ型前胶原（PCIll）水平较治疗前明显降低，且差异有统计学意义（P〈O．05）。治疗组治疗后ALT、TBil、血氨、LN和PCHI水平分别为（76．48±10．85）U／L、（71．81±16．67）μmol／L、（52．13±4．71）mmol／L、（100．53±5．73）μg/L和（107．36±11．30）μg/L，与对照组比较，组间差异均有统计学意义（t=4．569、4．012、2．187、2．021、3．232，P〈O．05）。治疗组总有效率与对照组相比差异有统计学意义（83．33％：56．67％，x2=0．535，P〈0．05）。结论血浆置换治疗对重型肝炎患者肝功能及肝纤维化指标均有明显改善作用，并能有效缓解患者的临床症状。

Effect of plasma exchange on fiver fibrosis indexes in severe hepatitis patients

Objective To explore the effect and clinical significance of plasma exchange to liver function and fibrosis indexes in severe hepatitis patients. Methods Sixty-six severe hepatitis patients in Sixth People＇s Hospital of Shaoxing were devided into 2 groups： control group （30 cases） and treatment group （36 cases）. The patients in the control group were given routine treatment of internal medicine, besides those the treatment group received the treatment of plasma exchange. The changes between two groups were observed before and after the treatment. Results In two groups, the level of ALT, TBil, laminin （LN） and procotlagen type 11I （PC 11I ） after treatment were lower than that before treatment, and there were statistically significant difference （P〈0.05） . After treatment, the level of ALT, TBil, NH3, LN and PC II1 in treatment group were （76.48±10.85） U/L, （71.81±16.67） μmol/L, （52.13±4.71） mmol/L, （100.53±5.73） p,g/L and （107.36±11.30）μg/L, and were significantly lower than that in control group （t=4.569, 4.012, 2.187, 2.021, 3.232, P〈0.05）. There was statistically significant difference in the total effective rates between the treatment group and the control group （83.33%：56.67%,x2=0.535 ,P〈0.05）. Conclusions Plasma exchange treatment can significantly improve the liver function and fibrosis indexes in pa- tients with severe hepatitis, and effectively relieve the clinical symptoms of the severve hepatitis patients.