关键词: 慢加急性肝衰竭, 双重血浆吸附联合血浆置换, 治疗, 疗效

Abstract: Objective The aim of this study was to investigate the clinical efficacy of double plasma adsorption and plasma exchange (PE) in treatment of patients with acute-on-chronic hepatitis B liver failure (ACLF). Methods 60 patients with ACLF were recruited in this study between September 2016 and October 2017, and were randomly divided into control group (n=30) and observation group (n=30). The patients in the observation group were treated with double plasma adsorption combined with PE, and those in the control group were treated with PE alone. All patients were followed-up for 3 months. Results At the end of 12 weeks, prothrombin time activity, serum albumin and bilirubin levels in the observation group were (75.3±2.8)%, (37.0±3.0)g/L and (180.2±93.0)μmol/L, significantly different as compared to 【(60.2±2.1)%, (33.6±2.5)g/L and (232.0±98.3)μmol/L, respectively, P＜0.05] in the control; blood hemoglobin and platelet counts were (103.2±22.1)g/L and (80.2±5.9)×10⁹/L, blood potassium, sodium and chlorine levels were (3.7±0.8)mmol/L, (137.1±5.0)mmol/L and (99.0±7.2)mmol/L, and serum creatinine level was (73.2±14.8)μmol/L, not significantly different as compared to those in the control 【(102.6±15.3)g/L,(75.5±6.0)×10⁹/L,(3.7±0.5)mmol/L,(137.5±8.0)mmol/L, (99.1±5.7)mmol/L and (73.5±15.5)μmol/L, respectively, P＜0.05】; the fatality rate in the observation was 16.7%, much lower than 33.3% in the control(P＜0.05). Conclusion The application of double plasma adsorption and PE in the treatment of patients with ACLF caused by hepatitis B infection might reduce the short-term mortality, which warrants further investigation.

Key words: Acute-on-chronic liver failure, Double plasma adsorption, Plasma exchange, Therapy, Efficacy