血浆置换联合双重血浆吸附模式人工肝治疗对纤维蛋白原的影响

肝脏 ›› 2023, Vol. 28 ›› Issue (5): 523-526.

血浆置换联合双重血浆吸附模式人工肝治疗对纤维蛋白原的影响

代梅, 申友书, 赵菲, 肖乐尧, 杨平, 罗亚文

563000 贵州遵义医科大学护理学院(代梅,申友书,赵菲,肖乐尧);遵义医科大学附属医院感染科(杨平,罗亚文)

收稿日期:2022-07-22 出版日期:2023-05-31 发布日期:2023-08-29
通讯作者: 杨平,Email:yangping199607@sina.com
基金资助:
贵州省科学技术厅基金资助项目(黔科合支撑[2021]一般049)

Effect of plasma replacement combined with dual plasma adsorption mode artificial liver therapy on fibrinogen

DAI Mei¹, SHEN You-shu¹, ZHAO Fei¹, XIAO Le-yao¹, YANG Ping², LUO Ya-wen²

1. School of Nursing, Zunyi Medical University, Guizhou 563000,China;
2. Department of Infection, Affiliated Hospital of Zunyi Medical University, Guizhou 563000,China

Received:2022-07-22 Online:2023-05-31 Published:2023-08-29
Contact: YANG Ping,Email:yangping199607@sina.com

摘要/Abstract

摘要： 目的比较单独血浆置换(plasma exchange, PE)和联合双重血浆吸附(double plasma molecular absorb system, DPMAS)人工肝治疗模式对慢性肝病患者纤维蛋白原的影响。方法选择2020年月—2022年5月于遵义医科大学附属医院就诊的58例终末期肝病患者为研究对象,其中29例患者接受PE治疗,29例患者接受PE+DPMAS治疗,比较两组患者治疗前后凝血功能(特别是纤维蛋白原)、肝功能指标的变化情况,治疗期间不良反应发生率。结果 PE组和PE+DPMAS组治疗前后纤维蛋白原、总胆红素、淋巴细胞绝对值、前白蛋白、ALT、AST、FAR、FPR比较,差异均具有统计学意义(P<0.05),且PE+DPMAS组患者纤维蛋白原的下降更为显著(1.76±0.62 vs 1.41±0.40, t=3.788, P<0.001)。PE+DPMAS组患者治疗后血小板水平显著低于治疗前(111.72±42.96 vs 93.69±48.33, t=2.753, P<0.05),但PE组患者治疗后血小板水平变化差异无统计学意义(95.97±47.73 vs 88.72±59.70, t=0.753, P>0.05),两组治疗前后白蛋白比较差异无统计学意义(P>0.05)。两组治疗过程中瘙痒(10.3% vs 10.3%)、皮疹(10.3% vs 3.4%)、血压、心率下降(3.4% vs 0.0%)、寒战、腹胀、呼吸困难发生率(0.0% vs 6.9%)比较,差异均无统计学意义(P>0.05)。结论与PE模式相比,PE+DPMAS人工肝模式对纤维蛋白原的损耗较大,且血小板降低更为显著,患者出血风险较PE治疗模式更高。

关键词: 血浆置换, 双重血浆分子吸附系统, 非生物型人工肝, 纤维蛋白原

Abstract: Objective To investigate the effect of plasma exchange (PE) and double plasma molecular adsorbent system (DPMAS) on fibrinogen in patients with chronic liver disease.Methods A totl of 58 patients with end-stage liver disease admitted to our hospital from January 2020 to may 2022 were selected as the research objects, among which 29 patients received PE treatment and 29 patients received PE+DPMAS treatment. Compare the changes of coagulation function (especially fibrinogen) and liver function indexes before and after treatment between the 2 groups, and the incidence of adverse reactions during treatment.Results The differences of fibrinogen, total bilirubin, absolute lymphocyte values, prealbumin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), fractional albuminuria rate (FAR), and formyl peptide receptor (FPR) before and after treatment were statistically significant (P<0.05) before and after treatment in 2 groups, and the decrease in fibrinogen was more significant (1.76±0.62 vs 1.41±0.40, t=3.788, P<0.001) in the PE+DPMAS. Platelet levels in the PE+DPMAS group were significantly lower than those in the PE+DPMAS group (111.72±42.96 vs 93.69±48.33, t=2.753, P<0.05), but there was no statistically significant difference in platelet level changes after treatment in the PE group (95.97±47.73 vs 88.72±59.70, t=0.753, P>0.05), and there was no statistically significant difference in albumin before and after treatment between the 2 groups (P>0.05). There was no significant difference in the incidence of pruritus (10.3% vs 10.3%), rash (10.3% vs 3.4%), blood pressure, decreased heart rate (3.4% vs 0.0%), chills, bloating, and dyspnea (0.0% vs 6.9%) between the 2 groups during treatment (P>0.05).Conclusion Compared with PE model, PE+DPMAS artificial liver model has greater loss of fibrinogen, more significant reduction of platelet, and higher bleeding risk than PE model.

Key words: Plasma exchange, Dual plasma molecular adsorption system, Abiotic artificial liver, Fibrinogen

代梅, 申友书, 赵菲, 肖乐尧, 杨平, 罗亚文. 血浆置换联合双重血浆吸附模式人工肝治疗对纤维蛋白原的影响[J]. 肝脏, 2023, 28(5): 523-526.

DAI Mei, SHEN You-shu, ZHAO Fei, XIAO Le-yao, YANG Ping, LUO Ya-wen. Effect of plasma replacement combined with dual plasma adsorption mode artificial liver therapy on fibrinogen[J]. Chinese Hepatolgy, 2023, 28(5): 523-526.

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