人工肝支持系统治疗药物性肝病患者的疗效观察

摘要

Objective To explore the clinical efficacy and safety of artificial liver support system in the treatment of drug-induced liver disease.Methods Eighty-eight cases of drug-induced liver disease were randomly divided into 2 groups, 44 cases in each group.2 groups of patients were received comprehensive treatment in the department of internal medicine;the patients in observation group were treated with artificial liver support system.Compared the changes of serum biochemical indexes including aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBil), total bile acid ( TBA) , prothrombin activity ( PTA) in the 2 groups of patients before and after treatment, and also observed the clinical effi-cacy.Results After treatment, AST, ALT, TBil, TBA were significantly decreased in both of the 2 groups, PTA increased significantly, and the change degree in observation group was significantly higher than that of control group ( t =2.383, 2.281,2.419,2.421, P <0.05).The observation group’s cure rate was 38.6%, the survival rate was 45.5%, death pa-tients’ mean survival time was (28.9 ±7.5) d, the control group were 15.9%, 27.3%and (15.6 ±4.2) d, the effect of observation group was significantly higher than that of control group (χ2 =2.365, 2.281,2.263, P <0.05).During the treatment, the observation group has 72 cases that were occurred with mild complications.Conclusion Artificial liver support therapy for patients with drug induced liver disease can significantly improve the cure rate and survival rate with high safety, can be applied in clinic.%目的：探讨人工肝支持系统治疗药物性肝病的临床疗效及安全性。方法药物性肝病患者88例采用随机数字表法分为2组，每组44例。2组患者均接受内科综合治疗，观察组患者在此基础上增加人工肝支持系统治疗。对比2组患者治疗前后血清生化指标的变化，包括天冬氨酸氨基转移酶（ AST）、丙氨酸氨基转移酶（ ALT）、总胆红素（ TBil）、总胆汁酸（ TBA）、凝血酶原活动度（ PTA）等，并观察临床疗效。结果治疗后2组患者AST、ALT、TBil、TBA均显著降低，PTA显著上升，且观察组改变程度显著大于对照组（ t ＝2憫．383、2．281、2．419、2．421， P ＜0．05）。观察组痊愈率为38．6％，存活率为45．5％，死亡患者平均存活天数为（28．9±7．5） d；对照组分别为15．9％、27．3％和（15．6±4．2）d，观察组疗效显著高于对照组（χ2＝2．365、2．281， t ＝2．263， P ＜0．05）。观察组治疗过程中发生并发症72例次，但均较轻微。结论人工肝支持系统治疗药物性肝病患者能够显著提高患者的治愈率和生存率，且安全性较高，可以在临床上进一步推广和使用。