双等离子分子吸附系统与连续低剂量等离子交换在患有乙型肝炎病毒相关的急性至慢性肝衰竭的患者:前性研究
Lu Wang1,2, Wenxiong Xu2,3, Shu Zhu2
1Second School of Clinical Medicine, Binzhou Medical University, Yantai, Shandong, China.
Journal of clinical and translational hepatology
|July 6, 2023
概括
双重血分子吸附系统与连续低剂量血交换 (DPMAS+LPE) 改善了B型肝炎病毒相关的急性至慢性肝衰竭 (HBV-ACLF) 患者的早期生存率. 这种治疗也减少了炎症标志物,这表明它可能对早期的HBV-ACLF产生影响.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 关键护理医学 关键护理医学
- 免疫学 免疫学 免疫学
背景情况:
- 与乙型肝炎病毒相关的急性至慢性肝衰竭 (HBV-ACLF) 是一个重大的临床挑战.
- 早期干预对于改善HBV-ACLF患者的治疗结果至关重要.
研究的目的:
- 评估用于早期HBV-ACLF的双重血分子吸附系统与序列低剂量血交换 (DPMAS+LPE) 的安全性和有效性.
- 为了比较DPMAS+LPE治疗与标准医疗治疗 (SMT).
主要方法:
- 一项涉及HBV-ACLF患者的前性研究,分为DPMAS+LPE和SMT组.
- 使用倾向-得分匹配来最大限度地减少混因素.
- 主要终点:12周死亡或肝移植 (LT);次要终点包括实验室参数和生存率.
主要成果:
- 在2周后,DPMAS+LPE组的总 bilirubin,ALT,BUN水平显著降低,而中国组的严重乙型肝炎研究得分显著降低 (p<0.05).
- 在4周的DPMAS+LPE组观察到显著更高的累积存活率 (97.9%对比85.4%,p=0.027),但在12周没有.
- 与非幸存者相比,在幸存者中观察到较低的细胞因子水平 (p<0.05),低调的细胞因子参与免疫和炎症反应.
结论:
- 在早期HBV-ACLF患者中,DPMAS+LPE显著提高了4周累积存活率.
- 治疗有效地改善了与HBV-ACLF相关的炎症反应.
- DPMAS+LPE显示为早期HBV-ACLF患者的治疗选择.
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