人工肝支持系统联合门冬氨酸鸟氨酸治疗重型肝炎的前瞻性研究

目的探讨人工肝支持系统联合门冬氨酸鸟氨酸（瑞甘）治疗重型肝炎的临床疗效。方法110例重型肝炎病人随机分成两组，治疗组55例给予注射用门冬氨酸鸟氨酸（瑞甘），对照组55例给予注射用腺苷蛋氨酸（思美泰）及谷氨酸钠，两组均给予人工肝支持治疗及其它基础综合治疗。结果治疗后wk2、wk4，治疗组和对照组肝功能较治疗前均有明显改善，治疗组肝功能改善情况明显优于对照组（P〈0.05），其中胆红素及血氨水平显著低于对照组（P〈0.01）；治疗组总有效率（83．6％）明显高于对照组（67．3％），差异有显著性（P〈0.05）；治疗组肝性脑病的发生率（12．7％）及病死率（14．5％）明显低于对照组（29．1％，30．9％），差异具有显著性（P〈0.05）。结论人工肝联合注射用门冬氨酸鸟氨酸（瑞甘）对重型肝炎病人肝功能改善疗效明显，并且能大大降低重型肝炎肝性脑病的发生率和病人的病死率。

Clinical efficacy of artificial liver support system and L-ornithine -L-aspartate on severe hepatitis

Objective To evaluate the therapeutic effect of artificial liver support system and L-ornithine -L-aspartate on severe hepatitis. Methods Totally 110 patients with severe hepatitis were randomly divided into two groups （n=55 for each group ）. The test group was treated with L-ornithine -L-aspartate and the control group was treated with ademetionine and glutamic sodium. The two groups were treated with artificial liver support system and combined therapy meanwhile. Results Either test group or control group can obviously improve hepatic function at the end of treatments, but the effect of test group was superior to that of control group especially on decreasing TBIL and blood ammonia （P〈0.01）. The overall effective rate of test group （83.6%） to improve hepatic function was higher than that of control group （67.3%, P〈0.05）. The incidence rate （12.7%） of encephalopathy and death rate （14.5%） of test group were lower than that of control group （29.1%, 30.9%, P 〈0.05）. Conclusions Artificial liver support system and L-ornithine -L-aspartate can markedly improve hepatic function of patients with severe hepatitis and reduce the incidence rate of encephalopathy and death rate.