肝脏 ›› 2017, Vol. 22 ›› Issue (4): 317-319.

• 论著 • 上一篇    下一篇

血浆置换对重症肝病患者血浆vWF水平的影响

许姗姗,陈亚利,林伟,陈煜,胡中杰,段钟平,张晶   

  1. 100000 北京佑安医院丙肝与中毒性肝病科
  • 出版日期:2017-04-30 发布日期:2017-04-30
  • 通讯作者: 张晶,Email:drzhangjing@163.com;段钟平,Email:duan2517@163.com
  • 基金资助:
    艾滋病和病毒性肝炎等重大传染病防治科技重大专项(2016ZX10004906-014);乙型重型肝炎肝衰竭优化诊疗方案研究(2016ZX10002008-04);乙型携带及重症患者临床干预与治疗研究(2016ZX10004906-014)

Effect of plasma vWF level on liver failure patients with plasma exchange

XU Shan-shan, CHEN Ya-li, LIN Wei, CHEN Yu, HU Zhong-jie, DUAN Zhong-ping, ZHANG Jing.   

  1. Beijing Youan HosPital, Capital Medical University, Beijing 100069, China
  • Online:2017-04-30 Published:2017-04-30
  • Contact: ZHANG Jing,Email:drzhangjing@163.com;DUAN Zhong-ping,Email:duan2517@163.com

摘要: 目的 观察血浆置换对重症肝病患者血浆vWF水平的影响。方法 前瞻性收集血浆置换治疗的重症患者临床资料及转归;采用ELISA法检测血浆置换前后血浆中vWF的含量。结果 共收集73例重症肝病患者,其中50例患者出院时病情好转,23例恶化。重症肝病组血浆vWF水平为60 215.0(19 412.4,127 995.0) ng/mL,显著高于正常对照组22 500.00 (5 760.00,44 700.00) ng/mL(P<0.05)。血浆置换后患者血浆vWF水平为42 855.1(12 714.5,115 684.7) ng/mL,与血浆置换前比较,差异有统计学意义(P<0.05)。好转组患者血浆vWF水平治疗后下降18 650.65 (1727.93, 81 110.42) ng/mL,显著高于恶化组7 517.82 (-25 045.33,22 718.17) ng/mL(P=0.005)。结论 血浆置换能够有效降低重症肝病患者血浆vWF水平,提示血浆置换有助于改善患者肝脏微循环状态,促进肝功能恢复。

关键词: 血浆置换, 重症肝病, vWF

Abstract: Objective To investigate the effect of plasma exchange (PE) therapy on plasma von Willebrand factor (vWF) level, and assess the value of artificial liver support system in the treatment of liver failure.Methods Seventy-three patients with liver failure was enrolled in the study. The clinical data was collected, and plasma vWF levels before and after PE treatment were measured using enzyme-linked immunosorbent assay (ELISA), respectively. Results With PE treatment, 50 patients recovered, while 23 patients deteriorated. The liver failure group had significantly higher level of vWF as 22 500.00 (5 760.00, 44 700.00) ng/mL than the normal group (P<0.05). Plasma vWF levels were statistically changed before and after PE treatment [60 215.0 (19 412.4, 127 995.0) ng/mL vs. 42 855.1 (12 714.5, 115 684.7) ng/mL, P<0.05]. Furthermore, decease of plasma vWF level in recovered group was 18 650.65 (1 727.93, 81 110.42) ng/mL, which was significantly higher than 7 517.82 (-25 045.33,22 718.17) ng/mL in deteriorated group (P=0.005). Conclusion PE therapy could effectively reduce plasma vWF levels and improve liver microcirculation, which promotes the recovery of liver function and prolongs the survival in patients with severe liver disease.

Key words: Artificial liver support system, Severe liver disease, Von willebrand factor