[Clinical research of plasma exchange with continuous veno-venous hemofiltration in treating mid- and late-stage chronic severe viral hepatitis B patients].
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.
Ye
Wei-jiang
WJ
Hangzhou Sixth People's Hospital, Hangzhou 310014, China. ywjhzsh@hz.cn
Li
Lan-juan
LJ
Yu
Hai-yan
HY
Zhang
Xin-ping
XP
Tian
Jing
J
Bai
Ming-hui
MH
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
D016209:Interleukin-8; D016753:Interleukin-10