人工肝血浆置换前后患者凝血功能和肝功能指标的变化

目的探讨重症肝病患者人工肝支持系统（ALSS）治疗前后凝血、肝功能的变化。方法在综合治疗的基础上50例重型肝炎患者进行人工肝血浆置换（PE）治疗，检测PT、APTT、TT、Fib采用凝固法，AT检测采用发色底物法，D—D检测采用免疫比浊法，肝功能检测采用速率法；分别应用ACL200型全自动血凝分析仪及其相配套的试剂和日立7600全自动生化分析仪检测。结果凝血指标PT、APTT、TT在ALSS治疗后缩短，Fib治疗后增加，D-二聚体减少，AT活性增加；ALT、AST和TBIL分别降低，ALB和CHE增加。结论人工肝支持系统是治疗重型肝病的有效方法，能够改善重症肝病患者的凝血、抗凝及肝功能。

The changes of the coagulation and liver function Indexes in patients with severe hepatic disease before and after the treatment with artificial liver support system

Objective To observe the effect of artificial liver support system on indexes of coagulation and liver function in patients with severe hepatopathy. Methods Based on integrated therapy 50 severe hepatitis patients were also treated with plasma exchange. The indexes of coagulation, anticoagulation, fibrinolysis and liver functions were assessed by Comparing the levels of PT, APTT, TT, Fib, D - D and AT before and after artificial liver support system treatment. Results The indexes of PT, APTT and Tr were shortened and that of D -D, ALT, AST, TBIL decreased （P 〈 0.01 ）, while that of Fib, AT, ALB and CHE increased （P 〈 0.01 ） after artificial liver support system treatment. Conclusion The artificial liver support system is an effective therapy for severe hepatitis and it can improve the coagulation - anticoagualtion and liver function in patients with severe hepatitis.