重型肝病患者人工肝治疗的生存分析

目的通过多中心、大样本的对照分析研究,探讨人工肝治疗对重型肝病患者生存期的影响。方法选择5家医院的肝病患者916例,将患者分为人工肝治疗组和常规内科治疗对照组,记录其诊断、分期等原始资料并进行随访,采用Kaplan-Meier方法和Log-Rank以及Breslow检验进行生存情况分析。结果人工肝治疗有延长生存时间的趋势;人工肝治疗对急性重型肝炎的生存时间有明显影响,能够延长急性重型肝炎患者的生存时间;人工肝对晚期患者的短期生存率有影响;人工肝治疗次数对患者生存时间有明显影响;人工肝治疗次数对急性重型肝炎和慢性重型肝炎患者的生存时间有明显影响。结论人工肝治疗能够延长急性重型肝炎患者、慢性及亚急性重型肝炎患者的生存时间,多次治疗效果显著优于单次治疗和内科治疗。

Survival Analysis on Liver Failure Patients Treated with an Artificial Liver Support System

Objective To evaluate the efficacy of artificial liver support system(ALSS) in the treatment of liver failure patients. This is a multi-center, controlled, large sample clinic trial. Methods 916 patients with liver failure from 5 hospitals were studied and followed. All the patients received similar pharmacological manipulation according to one and the same protocol but were divided into an ALSS treatment group and a control group without ALSS treatment. The analysis of survival time was computed using the Kaplan-Maier method, and comparison among groups was done using Log-Rank and Breslow test. Results ALSS has tendency to prolong the survival time; ALSS has obvious effect on survival time of acute liver failure and prolong their survival time; ALSS can affect the short-term survival time of advanced stage patients; ALSS times have an obvious effect on survival time of liver patients especially the acute severe hepatitis and chronic severe ones. Conclusion Multi ALSS treatment is more effective than the standard medicinal liver care treatment. Multi-ALSS treatment could increase survival time of patients suffering from acute liver failure or A and C liver failure. It is important and necessary to treat these patients with ALSS.