Comparisons of effects of different types of physical artificial liver support system applied in treatment of patients with early stage of chronic severe hepatitis / 中国中西医结合急救杂志

ABSTRACT

Objective To compare the different types of physical artificial liver support system(ALSS) applied in the treatment of patients with early stage of chronic severe hepatitis in order to evaluate the therapeutic effect and look for the most effective one.Methods One hundred and twenty patients of chronic severe hepatitis B in early stage were randomly divided into 4 groups(each n=30).The patients in group 1 were treated by 3 000 ml plasma exchange;in group 2,by 2 000 ml plasma exchange combined with plasma adsorption for 2 hours;in group 3,only by plasma adsorption for 3 hours and in group 4,by molecular adsorbent re-circulating system(MARS).The observation time lasted for 2 weeks and the therapy twice a week,the interval between two times of treatment being 2-3 days.The improvement of symptoms,the fade away and rebound of icterus,the changes of albumin and prothrombin activity(PTA),side effects(anaphylaxis,hepatic encephalopathy,edema of conjunctiva,burp,fluid and electrolyte balance failure,changes of blood routine test and ammonia level,etc) were compared before and after the treatment.Results The symptoms of 27 cases in group 1 were improved,the rate of decrease of total bilirubin(TBil) of group 1 was 51.8% and the range of icterus rebound was 14.4% to 46.7% with comparatively more side effects.The symptoms of 24 cases of group 2 were improved,the rate of decrease of TBil in group 2 was 62.2% and the range of icterus rebound was 2.8% to 28.5% with comparatively less side effects.The symptoms of 16 cases of group 3 were improved,the rate of decrease of TBil in group 3 was 38.8% and the range of icterus rebound was 2.8% to 6.8% with less side effects.The symptoms of 26 cases of group 4 were improved,the rate of decrease of TBil in group 4 was 60.1% and the range of icterus rebound was 7.8% to 27.4% with comparatively more side effects,moreover the cost was higher than that in the other groups.Conclusion The method of reduced plasma exchange combined with plasma adsorption with macroporous resin used to cure chronic severe hepatitis at early stage has the characteristic of good effects for the fade away of icterus,little rebound of icterus and side effects.It is the reasonable method of artificial liver to cure the early stage of chronic severe hepatitis.