TRAIL在重型肝炎患者PBMC和血清中的表达及血浆置换治疗前后的变化

Therapeutic effect of plasma exchange combined with bilirubin absorption for hyperbilirubinemia: An analysis of 42 cases

AIM: To analyze the therapeutic effect of plasma exchange (PE) combined with bilirubin absorption (BA) in the treatment of hyperbilirubinemia.

METHODS: Forty-two patients with hyperbilirubinemia (55 events altogether) treated by PE combined with BA, including 28 males and 14 females, were enrolled. Their mean age was 52.14 years ± 8.52 years.

RESULTS: The overall response rate was 95.24% for the combination treatment group and 76.66% for the normal treatment group. There was a significant difference in the overall response rate between the two groups (P < 0.05). Both groups had a significant improvement in liver function after treatment. The combination treatment was more effective in the improvement of TBil and alkaline phosphatase (ALP) levels (both P < 0.05).

CONCLUSION: PE combined with BA is safe and effective in the treatment of hyperbilirubinemia.

Relationship between hepatic dysfunction and prognosis in patients with paraquat poisoning: Clinical effects of hemopurification therapy

AIM: To investigate the relationship between hepatic dysfunction and prognosis in patients with paraquat poisoning, and to assess the clinical effects of hemopurification therapy [hemoperfusion (HP), continuous venovenous hemodiafiltration (CVVHDF), plasma exchange (PE)] in these patients.

METHODS: The clinical data for 55 patients with paraquat poisoning who were treated at EICU in our hospital from January 2009 to October 2012 were analyzed retrospectively. The patients were divided into two groups, death group and survival group. ALT, AST, TBIL and DBIL were measured on the 1st, 4th, 7th and 14th day after poisoning. The patients were then divided into two groups according to the use of CVVHDF therapy or not to evaluate the effect of this treatment on hepatic function.

RESULTS: At each time point, the levels of all the hepatic function parameters in the death group were significantly higher than those in the survival group (all P < 0.05). HP was performed in all patients. Two patients who received PE treatment were dead. The mortality in the CVVHDF group was significantly higher than that in the non-CVVHDF group (P < 0.01), and there was no significant difference for all liver function parameters at each time point between the CVVHDF group and non-CVVHDF group.

CONCLUSION: Paraquat poisoning can cause hepatic dysfunction. The changes in liver function parameters, especially high bilirubin, might be reliable predictors of prognosis. Hemopurification therapy, especially CVVHDF, is useless in patients with paraquat poisoning in terms of improving liver function and decreasing mortality.