ABSTRACT
Objective To explore the effect of low replacement plasma exchange(LPE)combined with double plasma molecular adsorption(DPMAS)in the treatment of patients with chronic acute liver failure(ACLF)and its influence on liver function,inflammatory cytokines and short-term prognosis.Methods One hundred patients with ACLF were randomly divided into the observation group and the control group by envelope method,with 50 cases in each group.On basis of routine symptomatic treatments(liver protection,removing jaundice,reducing enzymes,anti-viruses,bleeding prevention),the control group and the observation group were treated with plasma exchange(PE)and LPE plus DPMAS,respectively.The liver function,coagulation function,the levels of inflammatory cytokines,incidence of adverse reactions,and 90-day survival rate were compared between the two groups after treatment.Results After treatment,the liver function and coagulation function in the observation group were significantly improved(P＜0.05)and the levels of inflammatory cytokines were significantly lowered than those in the control group(P＜0.05).There was no statistically significant difference in the 90-day survival rate and the total incidence of adverse reactions between the groups(P＞0.05).Conclusion LPE combined with DPMAS can effectively improve liver function and coagulation function,and reduce levels of inflammatory cyto-kines in ACLF patients,with high safety.
ABSTRACT
Lymphoplasmapheresis(LPE) is a combination of plasma exchange and lymphocyte separation technology. It can not only remove autoimmune antibodies, but also remove the immune active cells producing these antibodies. At the same time, it can inhibit cellular and humoral immune responses, and improve the efficiency and reliability of treatment. This technology is safe, reliable, and easy to operate. In recent years, it has been widely used in the treatment of various autoimmune diseases and the suppression of immune rejection after organ transplantation, especially in the treatment of critically ill patients. This paper summarizes the clinical application status of LPE in immune-related diseases at home and abroad, analyzes the problems existing in the clinical promotion of LPE, and makes a prospect of its application value.
ABSTRACT
Objective To observe the therapeutic effect of lymphoplasmapheresis (LPE) in treatment of Guillain-Barre syndrome (GBS). Methods The initial recovery time of muscle strength, muscle strength score difference, clinical therapeutic effect and the security after treatment with LPE were observed in 34 GBS patients. Meanwhile, 17 GBS patients applied with therapeutic plasma exchange (TPE) named TPE group were served as control group. Results LPE group was treated with LPE 51 times in all, and the mean times was 1.5. TPE group received TPE 33 times in all, and the mean times were 1.9. In LPE group, the average initial recovery time [(12.74?7.18)d] was significantly shorter than that in TPE group [(24.35?14.22)d] (P0.05).Conclusions The therapeutic effect of LPE is distinguished for treatment with GBS and the side effect is rare. It is worth to apply in clinic.