Abstract: Objective The aim of this study was to investigate the efficacy of continuous renal replacement therapy (CRRT) without heparinization in patients with liver cirrhosis complicated by hepatic encephalopathy (HE), and its influence on blood ammonia and cytokine levels. Methods 62 patients with liver cirrhosis complicated by HE were enrolled in our hospital between January 2018 and January 2021. Among them, 31 patients received conventional liver protection and anti-hepatic coma treatment (control group), and on this basis, another 31 patients were treated with CRRT without heparinization (observation group). Serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and IL-10 levels were detected by enzyme-linked immunosorbent assay. Serum total bilirubin (TBIL), albumin (ALB) and ammonia levels were detected by fully automatic biochemical analyzer. Results The consciousness recovery time and hospital stay were(3.1±1.0)d and (8.1±1.3)d, both significantly shorter than [(4.8±1.1)d and (12.5±1.5)d, respectively, P<0.01] in the control, and the fatal rate was 6.5%, significantly lower than 25.8%(P<0.05) in the control; after treatment, serum ammonia, TNF-α and IL-6 levels were (69.3±10.5)mmol/L, (7.1±1.7)ng/L and (9.5±2.0)ng/L, all significantly lower than [(94.8±8.1)mmol/L, (9.4±1.9)ng/L and (12.4±2.5)ng/L, respectively, P<0.01] in the control, while there was no significant difference respect to serum IL-10 levels [(8.1±1.4)ng/L vs. (7.3±1.6)ng/L, P>0.01] in the two group ; total serum bilirubin level in the observation group was (41.2±8.6)μmol/L, significantly lower than [(50.4±9.7)μmol/L, P<0.05] in the control, while there were no significant differences respect to serum albumin levels [(32.9±3.2)g/L vs.(32.4±2.8)g/L] or INR [(1.2±0.4) vs. (1.3±0.4)] in the two groups (P>0.05). Conclusion The application of CRRT without heparinization is significantly efficacious in dealing with patients with liver cirrhosis and HE, and it could effectively reduce blood ammonia and cytokine levels and improve survival.

Key words: Hepatic encephalopathy, Liver cirrhosis, Continuous renal replacement therapy, Blood ammonia, Cytokines, Therapy