title: [Clinical research of plasma exchange with continuous veno-venous hemofiltration in treating mid- and late-stage chronic severe viral hepatitis B patients].
abstract: OBJECTIVE
  To evaluate the clinical efficacy and study the mechanism of combining plasma exchange and continuous veno-venous hemofiltration in treating patients with chronic severe viral hepatitis B in their mid- and late stages.
  
  
  METHODS
  94 patients suffering from chronic severe viral hepatitis B were divided into three groups. 29 patients were treated with plasma exchange plus continuous veno-venous hemofiltration (group A). 31 patients were treated with plasma exchange alone (group B). 34 patients received routine treatment (group C). The efficacy of treatment and survival rate of the three groups was investigated. Before and after artificial liver support system treatment the levels of cytokine were examined.
  
  
  RESULTS
  In group A, hyponatremia improved, the levels of interleukin 8 (IL-8) obviously decreased, the level of IL-10 increased, 5 of the 10 patients in coma regained normal consciousness (50.0%) and their survival rate was 48.3%. In group B, hyponatremia did not change, the level of IL-8 and IL-10 did not change. 2 of 11 patients in coma regained normal consciousness (18.2%) while survival rate was 22.6%. In group C, 1 of 11 patients in coma regained normal consciousness (9.1%) while survival rate was 20.6%.
  
  
  CONCLUSIONS
  It shows that plasma exchange with continuous veno-venous hemofiltration in treating patients with mid- and late stage chronic severe viral hepatitis B can increase the survival rate. IL-8 can be significantly removed, IL-10 significantly increased. This combined therapy is easy to practice, and should be used as an artificial liver support system.
authors.affiliation: Hangzhou Sixth People's Hospital, Hangzhou 310014, China. ywjhzsh@hz.cn
authors.forename: Wei-jiang
authors.initials: WJ
authors.lastname: Ye
authors.forename: Lan-juan
authors.initials: LJ
authors.lastname: Li
authors.forename: Hai-yan
authors.initials: HY
authors.lastname: Yu
authors.forename: Xin-ping
authors.initials: XP
authors.lastname: Zhang
authors.forename: Jing
authors.initials: J
authors.lastname: Tian
authors.forename: Ming-hui
authors.initials: MH
authors.lastname: Bai
mesh_terms: D000328:Adult; D005260:Female; D006440:Hemofiltration; D019694:Hepatitis B, Chronic / Q000628:therapy*; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D019164:Liver, Artificial; D008297:Male; D008875:Middle Aged; D010951:Plasma Exchange; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D016209:Interleukin-8; D016753:Interleukin-10