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