人工肝支持系统对重型肝炎患者生存时间的影响

Wen-fang Wu, Z. Jing
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摘要

目的评价人工肝支持系统(ALSS)治疗肝功能衰竭的疗效。方法采用多中心、对照、大样本临床试验。对来自6家医院的916例肝功能衰竭患者进行了研究和随访。所有患者均按照相同的方案进行类似的药理学操作,但分为ALSS治疗组和未进行ALSS治疗的对照组。生存时间分析采用Kaplan-Maier法计算,组间比较采用Log-Rank和Breslow检验。结果急性肝功能衰竭患者生存时间由4.0 d延长至8.0 d。ALSS可使急性肝功能衰竭患者的生存时间延长数倍。此外,它还增加了终末期肝衰竭患者的生存时间。两组终末期患者生存时间分别为51.0天和27.0天。结论ALSS有延长患者生存时间的倾向;ALSS对急性肝功能衰竭患者的生存时间有明显影响,可延长患者的生存时间;ALSS可影响终末期患者的短期生存时间;ALSS次数对肝脏患者生存时间有明显影响,尤其是急性重型肝炎、慢性重型肝炎和慢性重复肝炎患者。多重alss治疗比标准药物肝护理治疗更有效。多重alss治疗可延长急性肝衰竭或中末期肝衰竭患者的生存时间。对这些患者进行治疗是非常重要和必要的。
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Effect of Artificial Liver Support System on Survival Time of Severe Hepatitis Patients
Objective To evaluate the efficacy of artificial liver support system (ALSS) in the treatment of liver failure patients. Methods This is a multi-center, controlled, large sample clinic trial. 916 patients with liver failure from 6 hospitals were studied and followed. All the patients received similar pharmacological manipulation according to one and the same protocol but were divided into an ALSS treatment group and a control group without ALSS treatment. The analysis of survival time was computed using the Kaplan-Maier method, and comparison among groups was done using Log-Rank and Breslow test. Results Survival time of acute liver failure patients was prolonged from 4.0 days to 8.0 days. ALSS with many times increased the survival time of acute liver failure patients. In addition, it increased the survival time of the patients in end stage of liver failure. The survival time of end stage patients of the two times ALSS group and the control group was 51.0 days vs 27.0 days. Conclusion ALSS has tendency to prolong the survival time; ALSS has obvious effect on survival time of acute liver failure and prolong their survival time; ALSS can affect the short-term survival time of end stage patients; ALSS times have an obvious effect on survival time of liver patients especially the acute severe hepatitis and chronic severe ones and chronic repeat ones. Multi-ALSS treatment is more effective than the standard medicinal liver care treatment. Multi-ALSS treatment could increase survival time of patients suffering from acute liver failure or middle and end stage liver failure. It is important and necessary to treat these patients with ALSS.
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