Clinical Observation Of Plasma Exchange In The Treatment Of Severe Hepatitis And Analysis Of The Prognosis Factor Of Severe Hepatitis

Objective:1.to investigate the effect of plasma exchange(PE) which is one kind of artificial liver support system(ALSS) in the treatment of severe hepatitis.2.to explore the prognostic factors on patients with severe hepatitis.Methods:Clinical date of 78 patients with severe hepatitis were analyzed retrospectively.According to different therapy,these patients were divided into two groups:PE group and control group.The PE group was combined with plasma exchange based on conventional medication,while control group was only performed comprehensive medication.The blood was taken from those patients before plasma exchange and the end of the treatment to tested their TBil,ALT,ALB,Cr,BUN and electrolyte(K~+,Na~+,Cl~-),PT,PTA,etal.Observe the clinical symptom of patients, contrast patients'serum level of liver function,renal function and biochemical indexes, compare the efficiency of different stage of severe hepatitis.Evaluate the effect of gender,age,biochemical parameters and complication for the prognosis of severe hepatitis by univariate analysis.Results:Plasma exchange can improve clinical symptoms obviously,and the serum level of TBil,PT in cases treated with plasma exchange significantly decreased(p＜0.05). In the PE group there were 15 patients who have a remarkable effect,the improving rate was 48.4%.The improving rates of early,intermediate and late stage was 83.3%,62.5 %,0.In the control group the improving rate was 25.5%,and the improving rates of three stages was 42.9%,30%,0.Gender and age was not significantly related to the prognosis of patients with severe hepatitis.The serum level of TBil,CHOL,PT, PTA,AFP and the complication of improving group have significantly statistical differences compared with aggravation group(p＜0.05).Conclusions:Plasma exchange can effectively alleviate clinical symptoms,decrease the serum level of TBil and PT.Plasma exchange is more effective than conventional medication and has a remarkable effect on early stage patients.So the earlier the time of ALSS treatment,the beter the outcome is.The serum level of TBil,CHOL,PT, PTA,AFP and the complication were highly associated with prognosis of severe hepatitis.