分子吸附再循环系统对肝功能衰竭患者血清表皮生长因子水平影响.docVIP

分子吸附再循环系统对肝功能衰竭患者血清表皮生长因子水平影响 　 作者：刘芳，赵英仁，赵良，路长，龚玲 【摘要】 目的 评价分子吸附再循环系统（MARS）对血清表皮生长因子（EGF）浓度的影响。方法 通过ELISA方法，对比MARS治疗前后肝功能衰竭患者（20例次）血清EGF水平变化。结果 （1）经MARS治疗后，患者血清EGF浓度呈低幅上升（364.84 pg/ml vs 379.87 pg/ml，Pgt;0.05）。（2）MARS治疗前好转组EGF值较死亡组明显升高（427.23 pg/ml vs 288.60 pg/ml），经MARS治疗好转组下降（427.23 pg/ml vs 380.08 pg/ml），而死亡组上升（288.60 pg/ml vs 346.28 pg/ml）。（3）MARS治疗后，所有患者临床症状及体征均有不同程度改善，患者病死率46.67％，血清总胆红素（TBIL）明显降低（Plt;0.05），DBIL及TBA也有所下降，白蛋白浓度无明显改变。结论 MARS在清除患者机体毒性物质（胆红素、胆酸）的同时，不影响促进肝细胞生长的EGF水平，明显改善患者临床症状和体征，提高存活率。 【关键词】 分子吸附再循环系统 肝功能衰竭 表皮生长因子 ［Abstract］ Objective To evaluate the effect of MARS treatment on the concentration of EGF in the serum of liver failure patients,and instruct the clinical application of MARS.Methods The comparison of the concentration of EGF in the serum detected by ELISA between pretherapy and post-treatment was made in 15 liver failure patients.Results （1）The level of EGF in the serum rose slightly after treated with MARS.（2）The mean concentration of EGF in the improvement group was higher than death group before MARS treatment（427.23 pg/ml vs 288.60 pg/ml）.After MARS treatment,the EGF level in the improvement group decreased,while the EGF level in the death group increased.（3）All patients achieved different improvement in clinical symptoms and signs after MARS therapy.The overall mortality of MARS therapy was 46.67％ in 15 patients of liver failure.The level of TBIL in patients with liver failure decreased significantly after MARS（Plt;0.05）,and the concentrations of DBIL and TBA in the serum also reduced.There was no change in level of serum albumin.Conclusion The MARS technique does not influence the concentration of EGF characterized by promoting the hepatocellular regeneration.MARS treatment significantly improves the clinical symptoms and signs of patients with liver failure.MARS contributes to significant improvement of the survival rate in the patients with liver failure. ［Key words］ molecular absorbent recirculating system;liver failure;epid