[Influence of plasma exchange on serum cytokines in severe viral hepatitis patients]

To evaluate the changes of serum cytokines vary with plasma exchange (PE) therapy in patients with severe viral hepatitis.

Forty patients suffering from severe liver failure were randomized and treated by PE therapy. The tumor necrosis factor-alpha (TNF-alpha), interleukin-4 (IL-4) levels and liver function before and after PE therapy were examined. Moreover, the relation of TNF-alpha, IL-4 levels and the efficacy of PE, liver function and the compliment were also observed.

It showed that the TNF-alpha and IL-4 level of the serum were decreased after PE therapy. The TNF-alpha level of the serum was(79.32+/-22.39) ng/L before treatment and (20.01+/-22.25) ng/L after treatment (P<0.001), IL-4 was(0.61+/-0.07) ng/L before treatment and (0.57+/-0.06) ng/L after treatment (P<0.01). There were more differences between recovering patients and worsen ones (P<0.05 or P<0.01). There was remarkable difference between recovering patients and worsen ones in the liver function improvement (P<0.05 or P<0.01), the severe symptom ( P<0.01 and P<0.05) and the complication (P<0.01).

PE therapy can effectively purge or reduce TNF-alpha, IL-4 and is a method treating and preventing the complication. The worsen patients have continuous inflammation and higher level of TNF-alpha and IL-4.