RESUMEN
Objective To investigate the short-term efficacy of plasma exchange(PE),PE combined with double plasma molecule absorption system(PE+DPMAS) for treating severe hepatitis B(SHB).Methods The clinical data in 70 patients with SHB were retrospectively analyzed.The patients were divided into the PE group and PE+-DPMAS group according to different treatment modes.The clinical symptoms,liver function,coagulation function,blood routine,renal function and electrolytes changes,score decrease of model for end-stage liver disease(MELD) before and after treatment were compared between the two groups.Results After treatment,the alimentary tract symptoms were improved,the grade of hepatic encephalopathy was reduced and MELD score was decreased,but there was no statistically significant difference in the short-term effective rate between the two groups(P＞0.05).After treatment ALT,TBIL,RBC,Hb and PLT in the two groups were decreased significantly(P＜0.05);the ALB level in the PE+DPMAS group was decreased,while K+ and C1 were increased(P＜0.05);the PTA and ALB levels in the PE group were increased,while WBC was decreased in the PE group(P＜0.05).Conclusion The two kinds of treatment method PE and PE-+DP-MAS are effective in treating SHB.PE+-DPMAS can reduce the plasma usage and improve serum K+,Cl-levels;PE is superior to PE+DPMAS in the aspects of improving coagulation function and ALB level.
RESUMEN
Objective To observe the clinical efficacy of plasma exchange(PE),PE combined with plasma bilirubin absorp-tion(PE+PBA),and PE combined with double plasma molecule absorption system(PE+DPMAS),to investigate the best treat-ment options for the patients of hepatitis B-associated subacute severe.Methods Totally 140 patients who had hepatitis B-associat-ed were randomly divided into a PE group,a PE+PBA group,and a PE+DPMAS group.The dinical symptoms and blood rontine, electrolytc and the main biochemical indexes were recorded both before and after treatment and compared among the three groups. Results The total effective rate was higher in the PE +DPMAS group than in the PE group and PE+PBA group,which were 70.8%,60.9%,67.4% respectively,but there was no significant difference(P >0.05).compared with before treatment,serum total bilirubin (TBIL),alanine aminotransferase (ALT),aspartic acid amino shift enzyme (AST),valley aminoacyl transfer peptidase (GGT),alkaline phosphatase (ALP),globulin (GLB)and other biochemical indexes decreased significantly after treatment in 3 groups (P 0.05).Serum K+ and Cl- was obviously declined after treatment in the PE group,there was significant difference(P <0.001).Serum Na+ was obviously declined after treatment between the PE + PBA and PE + DPMAS groups (P < 0.001 ),but the difference was no significant in the PE groups.Serum Ca2+ was significantly decreased in the three groups of patients after treatment(P <0.001).WBC,Hb and PLT were significantly statistical difference after treatment(P <0.05).Conclusion The three groups also can improve liver function and the treatment rate for the patients of subacute hepatitis B-associated severe hepatitis.PE+PBA and PE+DPMAS groups can effective-ly reduce two thirds of the overall usage of the plasma.PE+DPMAS groups that the quantity of Cl- ,Ca2+ ,Hb decline much least in the three groups show larger value in the clinical application.