Effects of plasma exchange combined with double plasma molecule absorption system in treatment for patients with HBV related acute on chronic live failure

doi:10.3877/cma.j.issn.1674-1358.2016.06.006

Abstract

Abstract:

Objective

To investigate the effects of plasma exchange combined with double plasma molecule absorption system (PE + DPMAS) and only plasma exchange (PE) on patients with HBV related acute on chronic live failure, and to search a way of saving plasma.

Methods

Total of 98 cases with acute-on-chronic liver failure based on internal medicine comprehensive treatment were randomly divided, 51 cases treated by PE combined with DPMAS were collected as PE + DPMAS group, and 47 cases treated by only PE were collected as PE group, every case was treated for 2 to 3 times (every 5 to 7 days for one time). The improved condition on clinical symptoms and serum biochemical indexes before and after treatment in both groups were compared, respectively.

Results

The levels of serum TBil, ALT, AST, GGT, ALP, GLB and PT were significantly decreased after treatment in both groups (all P < 0.05). The levels of serum K⁺ and Cl^-were significantly decreased in patients of PE group (t = 4.015, 4.186; both P < 0.001). Compared with before treatment, the levels of serum Na⁺decreased after treatment in patients of PE + DPMAS group (t = 4.715, P = 0.000). The levels of serum Ca²⁺ were decreased after treatment in both groups, with significant difference (PE + DPMAS group: t = 4.306, P = 0.000; PE group: t = 16.528, P = 0.000). The total effective rate was 66.3% in all 98 cases, which was 70.6% in PE + DPMAS group, and 61.7% in PE group. The effect rates of PE + DPMAS group and PE group were not different significantly (χ²= 0.865, P = 0.352). Compared with PE group, PE + DPMAS treatment could save 50% to 60% plasma, with the incidence rates of skin pruritus urticaria and perioral numbness decreased from 80.8% to 17.6%, and 91.4% to 74.5%, respectively.

Conclusion

Both PE combined with DPMAS treatment and only PE treatment could improve liver functions for patients with acute-on-chronic liver failure, while PE + DPMAS treatment could reduce the levels of electrolyte ion and the incidence rate of adverse reactions, with better security, so as to improve the recent survival rate of the patients.

Key words: Acute on chronic live failure, Clinical treatment, Plasma exchange, Continuity plasma filter adsorb

Yongchao Xian, Shuquan Cheng, Jingyi Yang, Hui Ni, Chengjun Huang. Effects of plasma exchange combined with double plasma molecule absorption system in treatment for patients with HBV related acute on chronic live failure[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2016, 10(06): 674-679.

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组别	例数	年龄（岁）	性别[例（%）]
组别	例数	年龄（岁）	男性	女性
PE + DPMAS组	51	43.86±10.53	50（98.00）	1（2.00）
PE组	47	39.19±12.58	41（87.23）	6（12.77）
统计量		t = 0.717	χ² = 2.830
P值		0.482	0.920

组别	例数	年龄（岁）	性别[例（%）]
组别	例数	年龄（岁）	男性	女性
PE + DPMAS组	51	43.86±10.53	50（98.00）	1（2.00）
PE组	47	39.19±12.58	41（87.23）	6（12.77）
统计量		t = 0.717	χ² = 2.830
P值		0.482	0.920

指标	治疗前	治疗后	t值	P值
TBil（µmol/L）	360.34±149.73	186.45±81.85	14.726	< 0.001
ALT（U/L）	258.28±216.00	88.43±69.36	4.861	< 0.001
AST（U/L）	238.45±212.50	71.28±52.43	3.663	0.010
GLB（g/L）	27.26±6.75	21.17±4.32	7.797	< 0.001
GGT（mmol/L）	116.37±105.27	50.31±35.70	5.132	< 0.001
ALP（mmol/L）	150.19±50.12	86.11±25.64	5.884	< 0.001
PT（s）	24.79±10.21	19.43±4.15	13.735	0.030

指标	治疗前	治疗后	t值	P值
TBil（µmol/L）	360.34±149.73	186.45±81.85	14.726	< 0.001
ALT（U/L）	258.28±216.00	88.43±69.36	4.861	< 0.001
AST（U/L）	238.45±212.50	71.28±52.43	3.663	0.010
GLB（g/L）	27.26±6.75	21.17±4.32	7.797	< 0.001
GGT（mmol/L）	116.37±105.27	50.31±35.70	5.132	< 0.001
ALP（mmol/L）	150.19±50.12	86.11±25.64	5.884	< 0.001
PT（s）	24.79±10.21	19.43±4.15	13.735	0.030

指标	治疗前	治疗后	t值	P值
TBil（µmol/L）	396.62±126.92	226.42±68.19	13.651	< 0.001
ALT（U/L）	319.41±232.10	168.15±149.89	5.711	< 0.001
AST（U/L）	254.925±184.50	115.54±97.07	6.215	< 0.001
GLB（g/L）	26.30±6.42	21.91±4.39	5.132	< 0.001
GGT（mmol/L）	117.74±70.25	64.14±33.94	9.436	< 0.001
ALP（mmol/L）	158.63±56.19	115.87±60.21	4.792	< 0.001
PT（s）	25.75±3.98	23.84±2.35	5.241	< 0.001

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