血液灌流联合血液透析治疗药物性肝损害的临床疗效观察 李保华【1 3.docVIP

血液灌流联合血液透析治疗药物性肝损害的临床疗效观察 (1、第三军医大学西南医院全军消化内科中心 400038 2、第三军医大学) 【摘 要：目的：探索血液灌流(Hemoperfusion，HP)联合血液透析（Hemodialysis，HD）治疗药物性肝损害(drug-induced liver injury，DILI)的疗效，拟摸索出治疗药物性肝损害的血液净化方式。方法：选取2010年12月至2011年11月在第三军医大学西南医院消化内科中心治疗住院治疗住院第1周进行1-2次血液灌流联合透析治疗观察治疗后7天、14天及30天血清总胆红素(TBIL)的变化情况，进行疗效判定。结：1、第7天对照组下降。2、分别比较两组患者不同时象点总胆红素的下降速度，结果发现与对照组比较，治疗组于治疗后第7、14、30天时总胆红素下降速度明显快于对照组。结论：血液灌流联合血液透析治疗能提高药物性肝损害患者血清总胆红素降低速度，促进患者肝功能的恢复，对药物性肝损害患者应尽早应用，以获得最佳治疗效果。 关键词：药物性肝损害；血液灌流；血液透析；血清总胆红素。Clinical observation of hemoperfusion combined with hemodialysis in the treatment of drug-induced liver injury [Abstract] Objective To compare the effects on the hemoperfusion combined with hemodialysis and conventional therapy in the treatment of drug-induced liver injury. Methods Ten drug-induced liver injury patients with severe jaundice were randomly 作者介绍：李保华(1979 - )男，四川省仪陇人，消化内科主治医师，现在四川省仪陇县人民医院。电话：divided into a control group(C group), a hemoperfusion combined with hemodialysis(HP+HD) group, each group had 5 cases. The control group underwent conventional therapy, and the HP+HD group was treated with hemoperfusion combined with hemodialysis one or two times in the first week besides conventional therapy. Then the levels of serum total bilirubin(TBIL) were measured before treatment and at 7 days, 14 days and 30 days after treatment, and the decline levels of TBIL were also compared between the above groups at different time point. Results TBIL level of HP+HD group was significantly decreased at day 14 after treatment, and the decline of the TBIL was much higher at differernt time point compared to the C group. Conclusion HP+HD treatment could promote the cleanup of TBIL in drug-induced liver injury patients and prevent the liver function, then the patients may benefits a lot from the HP+HD application in the early stage of drug-induced liver injury Key words: Drug-induced Liver Injury; Hemoperfusion; Total Bilirubin 药物性肝损害是指应用治疗剂量的药物时肝脏受药物毒性损害或发生过敏反应