人工肝血浆置换联合血液滤过治疗猪急性肝衰竭实验研究

目的建立大动物急性肝功能衰竭动物模型,用于评价非生物型组合人工肝治疗效果。方法将中国实验小型猪12头随机分为对照组(n=6)与治疗组(n=6),静脉注射D-氨基半乳糖(1.2 g/kg)诱导建立急性肝衰竭动物模型。治疗组动物在给药后24 h及48 h分别进行2次血浆置换联合血液滤过治疗,对照组未行任何干预措施。观察比较2组动物生存时间、生化指标、颅内压与病理变化的差异。结果治疗组的生存时间较对照组明显延长,2组分别为(112.5±14.7)h和(67.9±9.4)h(P<0.01),治疗组多项生化指标、颅内压、细胞因子、组织病理等都较非治疗组动物有不同程度改善(P<0.05~0.01)。结论血浆置换联合血液滤过的非生物型组合人工肝治疗,能显著延长急性肝衰竭动物模型的生存时间,降低颅内压,改善生化、病理指标与近期预后,可作为肝脏移植和药物治疗的有效辅助手段。

Experimental Study on Artificial Liver for Pigs with Acute Hepatic Failure:Plasma Exchange and Hemofiltration

Objective To evaluate the efficacy of combined nonbioartificial liver(plasma exchange plus hemofiltration)for large animal model of acute hepatic failure induced by D-galactosamine.Methods 12 pigs were divided into two groups at random: control group(n=6) and treatment group(n=6).All of the animals were induced acute hepatic failure with adminis-tration of D-galactosamine firstly.24 h and 48 h later the animals in the treatment group were treated with plasma exchange(PE) combined with hemofiltration(HF) twice.Efficacy was assessed by comparing the survival time,improvement in manifestation,biochemical and pathological parameters.Results The treatment group's mean survival time was(112.5±14.7)h,which was much longer than that in the control group(67.9±9.4)h(P<0.01).There were significant differences for serum bilirubin,aminotransferase,ammonia,prothrombin time and histological manifestation between the two groups at the same time.Conclusion Combined nonbioartificial liver(PE plus HF) is effective for acute hepatic failure,and may be as a good bridging measure for liver transplantation and other methods.