Study On Efficacy Of ALSS For Chronic Severe Hepatitis And Effection On HepG2 Cell Apoptosis

Objective: To evaluate the clinical efficacy of ALSS for chronic severe viral hepatitis, and primarily investigate the effection of ALSS on HepG2 cell apoptosis.Methods: 101 patients with CSVH were studied. Besides the internal therapy, they were treated with ALSS 398 times, including plasma exchange (PE) 354 times, idiosyncracy bilirubin absorption (IBA) 19 times and protein adsorbent recycling system (PARS) 25 times. Before and post each performance, the biochemistry, ammonia, alpha fetoprotein, blood routine test, hemagglutination, humoral immunity and tumor necrosis factor alpha were detected. the variance of genreal clinical manifestations, adverse reaction and finnal clinical outcome were also record. In addition, other 51 CSVH patients were selected as control, and only accepted internal therapy. Finally, the cilinical efficacy was observed.Furthermore, HepG2 cells were cultured with the chronic severe hepatitis patients'plasma (before PE called SHP, after called SHP') , HBV-carriers'plasma/serum, well-beings'plasma/serum respectively, the proliferation activities of HepG2 were detected by MTT method, the apoptosis rates were detected by flow cytometry and Hoechst 33258 fluorescent staining, enzyme leakout (ALT,AST,LDH,GGT) in culture fluid were detected by biochemical instrument, the levels of Fas mRNA were detected by semi-quantitative RT-PCR.Results: 1. Before and after ALSS, there were no change in BRT, blood clotting function (except for PE) and humoral immunity factor significantly. In the course of programs, there were no severe adverse effects. After PE, the level of T-Bil, D-Bil, TBA and TNF-αdecreased, and that of Fbg increased significantly(P<0.01), clinical manifestations improved (over 80%). After IBA, T-Bil, D-Bil and TBA decreased significantly (P<0.01). After PARS, T-Bil, D-Bil and TBA reduced significantly, hyperuremia, hypercreatininemia, hyperammoniemia and electrolyte imbalance were corrected significantly (P<0.01). The survival rate of ALSS group was 55.4%, but 39.2% in the control group (P<0.01).