Title:Observation on the Effect of Sequentially Combined Multi-modal
Artificial Liver Treatment on HBV-related Acute-on-chronic Liver
Failure
Volume: 24
Issue: 9
关键词:
人工肝，序贯多模式治疗，肝功能衰竭，治疗效果，血小板计数，MELD。
摘要:
Objective: To observe the short-term effect of sequentially combined multimodal
artificial liver treatment (SCMALT) on HBV-related acute-on-chronic liver failure
(HBV-ACLF).
Methods: HBV-ACLF patients 155 cases undergoing artificial liver treatment were
analyzed, and they were sorted into the SCMALT group and the conventional-modal
artificial liver treatment (CALT) group. The clinical data of all patients were recorded
and the serum levels of interleukin-8 (IL-8), chemokine interferon-inducible protein-10
(IP-10), and interleukin-6 (IL-6) were detected. The changes in the 30-day survival
rate, cytokine level, model for end-stage liver disease (MELD) score, and
complications of artificial liver treatment were analyzed.
Results: After being followed up for 30 days, 104 patients survived and 51 died. At the
end of the whole-course treatment, the decreases in IL-6, IP-10, and IL-8 levels and
MELD scores in the SCMALT group were greater than in the CALT group. Cox
regression suggested WBC (OR=1.066, 95% CI 1.012-1.123, P=0.017), AT-III
activity (OR=0.935, 95% CI 0.907-0.964, p=0.000) at baseline, artificial liver
treatment mode (OR=0.362, 95% CI 0.164-0.800, p=0.012), number of artificial liver
treatments (OR=0.65695% CI 0.436-0.986, p=0.043), spontaneous peritonitis
(OR=0.337, 95% CI 0.165-0.689, p=0.003), and hepatic encephalopathy (OR=0.104,
95% CI 0.028-0.388, p=0.001) were independent influencing factors of 30-day
survival rate. SCMALT can significantly prolong the survival period of the patient. No
obvious difference was shown in the proportions of bleeding and circulation instability
between the two groups (p>0.05).
Conclusion: Compared with the CALT, SCMALT can more effectively remove
inflammatory mediators and reduce the MELD score in HBV-ACLF patients, which can
obviously ameliorate the prognosis, with less effect on the platelet count.
