| Objective:To explore the clinical efficacy of DPMASA+ Hepa Cure bio-artificial liver system in the treatment of liver failure.To evaluate the safety of HepaCure bio-artificial liver support system and to provide theoretical basis for clinical application of bio-artificial liver system.Methods:Patients who were in the Department of Infectious Disease of one hospital of Hunan Province from May 2017 to February 2018 suffering from acute-on-chronic liver failure,and were conducted with double plasma molecular adsorption(DPMAS)and HepaCure Bio-artificial liver system or Plasmapherfusion(PE)under the informed consent.16 patients had been treated with DPMAS+BAL.The treatment regimen consisted of 2 hours of dual plasma molecular adsorption system(DPMAS)treatment followed by 4-6 hours of HepaCure bioartificial liver treatment.Among the 10 cases,4 were treated once,6 were treated twice,and the average number of treatments was 1.6.The interval between the two treatment groups was 7 to 10 days.In order to evaluate the therapeutic effect of plasmapherfusion(PE),the clinical data of Plasmapherfusion(PE)patients were compared and analyzed.At the same time,immediate relevant immune indexes and relevant biochemical indexes were compared before and after treatment of HepaCure bioartificial liver support system,so as to comprehensively analyze the safety of HepaCure bioartificial liver.Results:(1)There were 10 patients selected in DPMAS+BAL group,and the overall improvement rate was 70%,survival rate of 28 days reached 100%There were 10 patients selected PF group,and the overall improvement rate was 30%,Survival rate of 28 days reavhed 90%.(2)Two groups of patients with different clinical factors(such as age,artificial liver type,number,etc.)with the correlation analysis showed that there is no statistical significance(P>0.05)between the efficacy of treatment and age,artificial liver type and treatment times.(3)The difference was statistically significant(P<0.05)in indexes of TBIL,AST,ALT and ALB in DPMAS+BAL group and PE group before and right after theoperation.In the comparison between the two groups,the decrease rate of TBIL and ALB in DPMAS+BAL group was higher than that in PE group,and the decline rate of AST and ALT in PE group was higher than that in DPMAS+BAL group(P<0.05).(4)Compared the rebound rate of TBIL,AST,ALT between DPMAS+ BAL and PE group in the 3 th,5 th,and 7th days,the rebound rate of TBIL?AST?ALT in DPMAS + BAL group were lower than that in PE group.PE,but the rebound rate of ALB in PE group was lower than that in DPMAS +BAL group,and there was a statistical significance(P<0.05).(5)Liver function and coagulation function in DPMAS+BAL group and PE group at the 7th,14th,21th,28th and 35th day after operation were compared with their preoperative baseline values,which indicates that:The total bilirubin in patients in DPMAS+BAL group of 21th,28th,35th day after the operation showed a downward trend compared with that of pre-operation and there is a statistical significance(P<0.05).The transaminase in patients in PE group of 7th,14th,21th,28th,35th day after the operation showed a downward trend compared with that of pre-operation and there is a statistical significance(P<0.05).There was no statistically significant difference between ALB,PT,APTT,PTA,INR and preoperative baseline values(P>0.05).(6)The changes of blood routine before and after the BAL treatment:hemoglobin and platelet decreased significantly after the treatment,and the difference was statistically significant(P<0.05),and the difference was not statistically significant(P>0.05)in the remaining indexes.(7)The difference was statistically significant(P>0.05)in renal function before and after the treatment in BAL.(8)Before and after treatment in BAL,the changes of electrolytes:K+,Mg2+ decreased and CL-increased after the treatment,and the difference was statistically significant(P<0.05).(9)The difference was not statistically significant(P>0.05)in complement level and immunoglobulin level before and after the treatment in BAL group.(10)There was no significant difference in morphology of hiHep cells before and after the treatment in BAL,but the difference was not statistically significant(P>0.05)in the number of living cells before and after treatment.(11)The incidence of adverse reactions in BAT support system therapy was 25%with no termination and malignant complications.Conclusion:(1)The DPMAS+ HepaCure bioartificial liver support system may support the acute or chronic liver failure by extending the survival of the patients with the acute or chronic liver failure,which lower the bilirubin and improve the coagulation function.(2)HepaCure There is a reliable safety in bio-artificial liver support system. |
PDF Full Text Request