DPMAS联合MPSS治疗慢加急性肝衰竭的疗效观察

目的 探讨双重血浆分子吸附系统（double plasma molecular absorb system，DPMAS）联合甲泼尼龙琥珀酸钠（methylprednisolone sodium succinate，MPSS）治疗慢加急性肝衰竭（acute-on-chronic liver failure，ACLF）的疗效。方法 选取2020年1月至2022年1月于杭州市西溪医院诊治的ACLF患者102例，采用简单随机法将其分为观察组和对照组，每组各51例。对照组患者给予MPSS静脉滴注治疗，观察组患者在对照组基础上联合DPMAS治疗。比较两组患者的临床疗效、肝功能天冬氨酸转氨酶（aspartate aminotransferase，AST）、丙氨酸转氨酶（alanine aminotransferase，ALT）、总胆红素（total bilirubin，TBIL）]、凝血功能凝血酶原时间（prothrombin time，PT）、活化部分凝血活酶时间（activated partial thromboplastin time，APTT）、纤维蛋白原（fibrinogen，FIB）]和甲状腺激素游离三碘甲腺原氨酸（free triiodothyronine，FT3）、游离甲状腺素（free thyroxine，FT4）、促甲状腺激素（thyroid stimulating hormone，TSH）]。结果 观察组患者的总有效率显著高于对照组（2=4.194，P=0.041）。治疗后，两组患者的AST、ALT和TBIL均显著低于本组治疗前，PT、APTT均显著短于本组治疗前，FIB、TSH均显著高于本组治疗前（P<0.05），观察组患者的AST、ALT和TBIL均显著低于对照组，PT、APTT均显著短于对照组，FIB、TSH均显著高于对照组（P<0.05）。结论 DPMAS联合MPSS治疗ACLF疗效显著，可改善患者的肝功能、凝血功能和甲状腺激素水平。

Effect of DPMAS combined with MPSS in treatment of acute-on-chronic liver failure

Objective To investigate the efficacy of double plasma molecular absorb system (DPMAS) combined with methylprednisolone sodium succinate (MPSS) in treatment of acute-on-chronic liver failure (ACLF). Methods A total of 102 ACLF patients diagnosed and treated in Hangzhou Xixi Hospital from January 2020 to January 2022 were selected and divided into observation group and control group by simple random method, with 51 cases in each group. Patients in control group were given intravenous infusion of MPSS, and patients in observation group were combined with DPMAS on the basis of control group. The clinical efficacy, liver function aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBIL)], coagulation function prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB)] and thyroid hormone free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH)] were compared between the two groups. Results The total effective rate of observation group was significantly higher than that of control group (2=4.194, P=0.041). After treatment, AST, ALT and TBIL in two groups were significantly lower than before treatment, PT and APTT were significantly shorter than before treatment, FIB and TSH were significantly higher than before treatment (P<0.05). AST, ALT and TBIL in observation group were significantly lower than those in control group, PT and APTT were significantly shorter than those in control group, FIB and TSH were significantly higher than those in control group (P<0.05). Conclusion DPMAS combined with MPSS is effective in treatment of ACLF, which can improve liver function, coagulation function and thyroid hormone levels.