Effects of artificial liver plasma exchange on cytokines in patients with liver failure / 临床肝胆病杂志

ABSTRACT

Objective To observe the effect of plasma exchange (PE)therapy for removing serum interleukin-6 (IL-6),tumor necrosis factor alpha (TNFα),and interferon gamma (IFNγ)in patients with liver failure,and to assess the value of artificial liver support system in the treatment of liver failure.Methods The study included 36 patients with liver failure who were hospitalized in the First Affiliated Hospi-tal of Bengbu Medical College from February 2012 to February 2013.Blood samples were collected before PE and the next morning after mul-tiple treatments.Plasma TNFα,IL-6,and IFNγlevels were measured by ELISA.Between-group comparison of measurement data before and after treatment was made by independent-samples t test,and comparison of mean values between groups was made by analysis of vari-ance.Results All the 36 liver failure patients had significantly lower levels of TNFα(381.23 ±190.57 ng/L vs 274.12 ±212.30 ng/L,P0.05).After PE therapy,29 out of 36 liver failure patients recovered well,while the remaining 7 patients deteriorated.The recovered group had significantly greater decreases in TNFα(122.58 ±57.64 ng/L vs 42.45 ±19.86 ng/L,P<0.05),IL-6 (26.93 ±7.25 ng/L vs 6.71 ±3.55 ng/L,P<0.05),and IFNγ(284.06 ±94.31 ng/L vs 217.47 ±45.76 ng/L,P<0.05)than the deteriorated group.The response rates of patients with acute,subacute,acute -on -chronic,and chronic liver failure were 66.67%,85.71%,86.36%,and 50%,respectively.Conclusion Continuous artificial liver PE therapy can effectively remove pro-inflammatory cytokines from plasma and thus improve the clinical outcomes of patients with liver failure.