Plasma exchange combined with double plasma absorption therapy improve the prognosis of acute-on-chronic liver failure
10.3760/cma.j.issn.1007-3418.2018.10.003
- VernacularTitle: 血浆置换联合双重血浆吸附治疗提高慢加急性肝衰竭预后
- Author:
Shan ZHONG
1
,
2
,
3
;
Na WANG
;
Jing ZHAO
;
Li ZHANG
;
Ling LUO
;
Weiqun ZENG
;
Xiaofeng SHI
;
Zhiyi WANG
;
Dachuan CAI
;
Dazhi ZHANG
;
Zhi ZHOU
;
Peng HU
Author Information
1. Department of Infectious Diseases, the Second Affiliated Hospital, Chongqing Medical University
2. Viral Hepatitis Research Department, Chongqing Medical University
3. Key Laboratory of Molecular Biology for Infectious Diseases, Ministry of Education and Department of Infectious Disease, Chongqing Medical University, Chongqing 400010, China
- Publication Type:Journal Article
- Keywords:
Liver failure;
Non-bioartificial liver support system;
Plasma exchange;
Double plasma molecular absorption system
- From:
Chinese Journal of Hepatology
2018;26(10):744-749
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the efficacy and safety of plasma exchange (PE) combined with double plasma absorption and simple PE in the treatment of acute-on-chronic liver failure.
Methods:We retrospectively analyzed 251 cases of acute-on-chronic liver failure treated with artificial liver treatment since January 2015. Changes in clinical manifestations, laboratory tests, and complications of the patients before and after different modes of treatment were compared and short-term efficacy was tracked. In accordance with different data, t-test, Pearson's chi-squared test and Fisher's exact test were used for statistical analysis.
Results:The effectiveness of low-volume PE combined with double plasma molecular adsorption system (DPMAS) and equal amount of PE combined with DPMAS was significantly better than simple PE (83.7%, 84.05% and 82.15 vs 55.6%, P < 0.05) in early stage of liver failure. In late-stage of liver failure, there was no significant difference in the treatment efficiency of each group (P > 0.05). Bilirubin and bile acid levels were significantly decreased in combined treatment groups than that to simple PE group (P < 0.05). PTA and albumin improvement rate of DPMAS PE groups were significantly lower than that of simple PE group (P < 0.05). There was no statistical difference in adverse reactions between each group.
Conclusion:PE combined with DPMAS improves the treatment efficiency of early hepatic failure and decrease dosage of plasma when compared with simple PE. A beforehand DPMAS treatment after PE treatment can improve the adverse effects of DPMAS on blood coagulation function and albumin levels.
