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find Keyword "肝支持系统" 4 results
  • 急性肝功能衰竭大动物模型研究进展

    【摘要】 急性肝功能衰竭(acute liver failure,ALF)是一种极为严重且进展迅速的临床综合症且最具挑战性临床医学问题,鉴于对ALF认识不足及对患者进行研究的困难,建立准确反映人ALF临床特征的动物模型至关重要。目前ALF大动物模型众多。主要应用猪、狗,通过手术方法(全肝切除、部分肝切除、肝缺血)或化学药物方法(醋氨酚、D-氨基半乳糖、四氯化碳等)建模。然而现今的模型都不能准确地重现人ALF,都有其局限性。可喜的是兔出血病病毒模型可很好重现人ALF临床生理、生化特征,但兔同人差异大。进一步尝试建立大动物感染模型以及非人灵长类动物模型十分必要,且将是未来趋势。

    Release date:2016-09-08 09:24 Export PDF Favorites Scan
  • 人工肝支持系统的临床应用

    【摘要】人工肝支持系统是一套以血液净化为基础的治疗方法,并在缓解重型肝炎患者的病情、延长其生命、争取肝移植时间等方面取得。现就近年来国内外非生物型人工肝的发展现状及其临床应用作一综述。

    Release date:2016-09-08 09:50 Export PDF Favorites Scan
  • Application of Artificial Liver Support System in Liver Failure and Liver Transplantation

    【Abstract】Objective To evaluate effect of artificial liver support system (ALSS) in liver failure and liver transplantation.Methods Forty-four patients with liver failure (including 12 undergoing liver transplantation) were treated with MARS or plasma exchange. The changes of toxic substances and cytokines in blood were detected before and after treatment. Results ALSS therapy achieved a remarkable improvement in clinical symptoms and physical signs. After ALSS treatment, there was a significant decrease in total bilirubin, total bile acid, alanine aminotransferase, creatinine, urea nitrogen, blood ammonia and endotoxin levels(P<0.05); the levels of serum NO, TNF-α, IL-4 and IL-6 were significantly decreased(P<0.05); there was no statistical change in erythrocytes, leukocytes and platelets. The survival rate of 30 liver failure patients caused by severe hepatitis B was 60.0%(18/30). Six patients with acute liver failure were successfully performed liver transplantation. Two patients in 6 with acute liver failure after liver transplantation survived. One patient in 2 with acute liver failure after pancreatoduodenectomy survived. Conclusion ALSS plays a positive role in treatment of liver failure by removing blood toxins, NO and cytokines. ALSS also plays a substitute role for liver failure patients who are waiting for liver transplantation.

    Release date:2016-09-08 11:54 Export PDF Favorites Scan
  • Analysis of Prognostic Factors for Short-term Outcome in Patients with Hepatitis B Virus-related Acute-on-chronic Liver Failure Treated with Artificial Liver

    ObjectiveTo learn the outcomes of hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) cases after artificial liver support system (ALSS) treatment and the relevant factors correlated with the clinical outcomes. MethodsIn the period from January 2011 to June 2014, 321 patients with HBV-ACLF were admitted to West China Hospital. The clinical data at baseline, before and after treatment were analyzed by univariate and multivariate logistic regressions to identify the independent risk factors correlated with 30-day outcomes. ResultsOf all the 321 patients, 233 survived and 88 died by the end of a 30-day observation. The univariate analysis identified that the incidences of cirrhosis, hepatorenal syndrome and peritonitis in the death group were significantly higher (P<0.05). The model for end-stage liver disease values, white blood cells (WBC), blood ammonia, creatinine and total bilirubin (TBIL) at different stages in the death group were significantly higher than those in the survival group (P<0.05). In the death group, the HBV-DNA, TBIL decrease after triple ALSS treatments, baseline prothrombin time activity (PTA) and PTA level after triple ALSS treatments were significantly lower (P<0.05). The multivariate logistic regression indicated that WBC (OR=2.337, P<0.001) and TBIL level after triple ALSS treatments (OR=4.935, P<0.001) were independent predicting factors for death within 30 days after ALSS treatment; HBV-DNA (OR=0.403, P<0.001), the decrease of TBIL after triple ALSS treatments (OR=0.447, P<0.001) and PTA level after triple ALSS treatments (OR=0.332, P<0.001) were protecting factors for the 30-day prognosis. ConclusionThese five factors including WBC, HBV-DNA, PTA, TBIL and TBIL decrease after triple ALSS treatments influence the short-term prognosis for HBV-ACLF patients, which are valuable for decision making in clinical practices.

    Release date:2016-10-02 04:54 Export PDF Favorites Scan
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