Clinical characteristics and efficacy of the plasma exchange artificial liver therapy in patients with acute-on-chronic liver failure
- VernacularTitle:血浆交换人工肝治疗慢加急性肝衰竭患者的临床特征及疗效分析
- Author:
Kai DENG
1
;
Jiaqi CUI
Author Information
- Publication Type:Journal Article
- Keywords: artificial liver therapy; acute-on-chronic liver failure(ACLF); model for end-stage liver disease(MELD)score; complication
- From: Journal of Xi'an Jiaotong University(Medical Sciences) 2025;46(4):671-676
- CountryChina
- Language:Chinese
- Abstract: Objective To observe the clinical characteristics and efficacy of plasma exchange artificial liver therapy in patients with acute-on-chronic liver failure(ACLF).Methods A total of 135 patients with ACLF treated in our hospital from May 2023 to May 2024 were selected as the study subjects.They were divided into two groups based on different treatment methods:plasma exchange artificial liver therapy group(54 cases)and conventional therapy group(81 cases).Patients received different treatment according their liver function and coagulation function.We compared the laboratory test results,clinical efficacy,cytokine levels,and incidence of complications between the two groups of patients.Results The MELD score of patients was significantly higher in the artificial liver treatment group(2 527.96±1 504.21)than in the conventional group(1 854.75±940.23)(P=0.004),and the incidence of diabetes,coronary heart disease and liver cancer in the former group was significantly higher than that in the latter group(P=0.030,0.030).The total serum bilirubin,direct bilirubin,interleukin-6(IL-6),C-reactive protein(CRP),alpha fetoprotein,lymphocyte/monocyte ratio,and direct bilirubin/partial thromboplastin time ratio(PTR)in the artificial liver treatment group were significantly higher than those in the conventional group(P values＜0.001,＜0.001,0.040,0.030,0.040,and 0.006,respetively),while uric acid levels were significantly lower than those in the conventional group(P=0.040).The artificial liver treatment group had significantly lower incidence of infection and ascites during treatment than the conventional group(P=0.010,0.020).After artificial liver treatment,the patients' levels of IL-6,CRP,and alpha fetoprotein were significantly reduced.Conclusion Patients with complex chronic and acute liver failure are more recommended to directly undergo plasma exchange artificial liver treatment,which has definite efficacy and fewer complications.IL-6,CRP and alpha fetoprotein dynamically monitored can be regarded as indicators for efficacy of artificial liver treatment.
