血浆置换治疗重型肝炎对病毒载量的影响及临床意义

目的观察并探讨血浆置换（PE）治疗后重型肝炎患者血清中HBV-DNA载量的变化及其临床意义。方法随机选取48例乙型肝炎病毒标志物阳性的重肝患者，在内科基础治疗上加用血浆置换治疗。观察患者在PE治疗前后血清中HBV-DNA载量的变化及各项肝功能指标的变化。结果48例患者经PE治疗，血清HBV∈DNA载量明显下降，治疗有效组比治疗无效组降低更明显，对肝功能和临床症状的改善也更明显。结论PE治疗可有效去除重型肝炎患者血清中HBV-DNA，从而减轻由其诱发的机体免疫反应，改善临床症状及肝功能，提高患者的存活率。

Effect of Plasma Exchange on Serum Level of HBV- DNA and Its Clinical Significance in Patients with Severe Hepatitis

Objective To observe and evaluate the effect of plasma exchange(PE) on the serum level of HBV-DNA and its clinical significance in patients with severe hepatitis.Methods PE treatment on the basis of medical treatment was performed in 48 patients with severe hepatitis B, who were randomly selected from the patients with severe hepatitis B treated in our department from October 2000 to October 2003. The serum level of HBV - DNA and liver function before and after PE therapy were examined. Results The serum level of HBV-DNA was significantly decreased and the liver function were significantly improved after PE therapy compared to the pretreatment (P<0.01) in all the patients.The decrease in the level of serum HBV-DNA and the improvement in the liver function in the recovering patients were more significant than those in the unchanged patients (P<0.01). Conclusions The PE therapy can effectively purge the serum of HBV- DNA in patients with severe hepatitis B, reduce the int(?)nunoreactions.and improve the liver function.The survival rat of the patients should be increased.