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目的 研究人工肝支持系统血浆置换疗法治疗慢性重型肝炎的临床疗效 ,探讨血浆内毒素、转化生长因子 β1(TGF β1)、一氧化氮 (NO)、肝细胞生长因子 (HGF)在慢性重型肝炎发病机制中的作用。方法 将 5 9例慢性重型肝炎患者随机分为治疗组与对照组。两组入院后均给予内科综合治疗 ,治疗组 34例加用人工肝支持系统血浆置换治疗。观察治疗前后肝功能、血浆内毒素、TGF β1、NO、HGF水平变化。结果 治疗组治疗后肝功能明显改善 ,生存率较对照组提高 (P <0 0 5 ) ;血浆内毒素、TGF β1、NO水平较对照组明显下降 (P <0 0 5、P <0 0 1、P <0 0 1) ;血浆HGF水平上升较对照组明显 (P <0 0 1)。结论 人工肝支持系统血浆置换疗法能有效清除血浆内毒素、TGF β1、NO毒性物质和肝细胞再生抑制因子 ,提高血浆HGF含量 ,减轻肝细胞炎症、促进肝细胞再生 ,提高慢性重型肝炎生存率。
Objective To study the clinical efficacy of artificial liver support system (PSCT) plasmapheresis in the treatment of chronic severe hepatitis and to explore the clinical significance of plasma endotoxin, transforming growth factor β1 (TGFβ1), nitric oxide (NO) and hepatocyte growth factor (HGF) Mechanism of the role. Methods A total of 59 patients with chronic severe hepatitis were randomly divided into treatment group and control group. Two groups were given comprehensive medical treatment after treatment, the treatment group 34 cases with artificial liver support system plasma exchange therapy. The changes of liver function, plasma endotoxin, TGFβ1, NO, HGF level before and after treatment were observed. Results The liver function of the treatment group was significantly improved after treatment, and the survival rate was higher than that of the control group (P <0.05). The levels of plasma endotoxin, TGFβ1 and NO were significantly decreased compared with the control group (P <0.05, P <0.01 , P <0.01). The level of HGF in plasma increased significantly compared with the control group (P <0.01). CONCLUSION: The plasma exchange system of artificial liver support system can effectively remove plasma endotoxin, TGFβ1, NO toxic substances and hepatocyte regeneration inhibitory factor, increase plasma HGF content, reduce hepatocellular inflammation, promote hepatocyte regeneration and improve the survival rate of chronic severe hepatitis.