Abstract: Objective To investigate the efficacy of plasma exchange （PE） and continuous plasma dialysis filtration （CPDF） in the treatment of patients with acute-on-chronic liver failure （ACLF）.Methods 92 patients with ACLF were recruited between March 2012 and April 2017,and 46 patients in the control was treated with routine supporting treatment and another 46 in the observation was treated with combination of PE and CPDF at the basis of conventional treatment. Serum cytokine,endotoxin,aromatic and branched-chain amino acid levels were assayed.Results After treatment,the international standardized ratio（INR） of prothrombin time and total serum bilirubin in the observation group were significantly lower than while serum albumin level were significantly higher than in the control（P<0.05）;serum tumor necrosis factor,interleukin （IL）-6 and IL-8 levels in the observation group were significantly lower than those in the control group [（68.9±43.3） pg/ml vs.（89.7±39.5） pg/ml,（53.3±39.7） pg/ml vs. （69.4±41.2） pg/ml,and （271.7±135.4） pg/ml vs. （307.6±147.2） pg/ml, P<0.05];blood endotoxin level was 0.2（0.2,0.4）EU/ml,much lower than 【1.1（0.8,1.7） EU/mL,P<0.05】,blood ammonia level was （64.8±19.4） μg/L,much lower than【（80.3±31.1） μg/L,P<0.05】,and aromatic amino acid levels was 2.1（1.5,2.7） mg/dL,much lower than 【（2.3（1.8,2.5） mg/dL,P<0.05】,while branched-chain amino acid levels was（2.6±0.5） mg/dL,much higher than【（2.1±0.1）mg/dL,P<0.05】 in the control;the fatality rates in the two groups at the end of six month treatment were not significantly different （32.6% vs. 43.5%,P>0.05）. Conclusion The application of PE and CPDF in treatment of patients with ACLF might decrease blood cytokine,endotoxin,ammonia and aromatic amino acid levels,which warrants further investigation for their clinical efficacy.

Key words: Acute-on-chronic liver failure, Plasma exchange, Continuous plasma dialysis filtration, Cytokines, Therapy