Clinical Efficacy And Evaluation Of Artificial Liver Support System With Plasma Exchange Therapy On 104 Cases With Chronic Severe Hepatitis B

Objective: In order to evaluation the efficacy and affecting factors during the therapy of plasma exchange(PE) treatment on chronic severe hepatitis B, liver function index,times of PE,serum endotoxin lever,etc were discussed separately.Methods: 104 cases with chronic severe hepatitis B were enrolled in this study, and all the cases were from the Infections Diseases Centre of West China Hospital. There were two groups from these patients, between which the only difference was that therapy group has been performed with PE treatment while the other control group hasn't. Both of clinical results and symptom from two groups before and after treatment were observed and analysed.Difference outcomes between different times of PE treatment were also analysed at the same time. Furthermore, 27 cases from therapy group were serily tested for serum endotoxin level before and after PE therapy and the results were compared depending on the patients outcome.Results: The improvement rate of forepat and middle stage cases in the therapy group and control group were 54.4% and 27.8% respectively, from that the diversity has statistical meaning (P＜0.01); while the results of late stage were 8.3% and 1.4%, from which there was no statistical meaning (P＞0.05). All those clinical symptoms and blood test results were mended variously. Improvement rate of cases with different times from 2 to 4 of PE treatment were 39.4%,43.6% and 42.9% respectively, with no statistical difference (P＞0.05). On the other hand, remarkable improvement about serum endotoxin level had been observed after PE treatment (82.2% Vs 10%), similar results also found among those cases who had got better outcome with statistical meaning (P＜0.01).Conclusion: Plasma exchange treatment could obviously improve liver function index, especially for those who were forepat and middle stage of chronic severe hepatitis B. No statistic meaning had been observed between different times of PE therapy. Serum endotoxin level was absolutely related with the prognosis of these cases with chronic severe hepatitis B. It was found in this study that Serum endotoxin level was original lower or falling down after PE treatment in some cases would have some better prognosis, while reversely, the prognosis would be much more worse.