[Comparison of curative effect of low flow rate plasma exchange combined with hemofiltration for treatment of liver failure].
OBJECTIVE
To investigate the effect of plasma exchange (PE) combined with hemofiltration (HF) on liver failure.


METHODS
Seventy-seven inpatients with liver failure admitted during January 2006 to August 2007 were randomly assigned to receive PE combined with HF (PE+HF group, 38 cases), or PE alone (PE group, 39 cases). Forty-one inpatients with liver failure who had not received artificial liver support treatment were assigned to serve as control group. The survival rates and biochemical parameters of three groups were compared.


RESULTS
There was no significant difference in biochemical parameters before treatment among three groups. Compared with pre-treatment values, albumin (Alb), cholinesterase (ChE) and prothrombin activity (PTA) of both PE group and PE+HF group were significantly increased after treatment, and total bilirubin (TBIL), alanine transaminase (ALT), aspartate transaminase (AST) of both PE group and PE+HF group were significantly decreased after treatment (P<0.05 or P<0.01). The survival rate of PE group, PE+HF group and control group was 48.7% (19/39), 68.4% (26/38), and 29.3% (12/41) respectively. The survival rate of PE+HF group was significantly higher than that of control group (chi(2)=12.11, P<0.01). The rate of recovery of consciousness of patients with hepatic encephalopathy in PE+HF group was higher than that of PE group (42.8% vs. 0, P<0.05). Compared with PE alone, the result was better when it was combined with HF in correction of electrolyte disturbance and acid-base imbalance (19/23 vs. 0/21, P<0.05).


CONCLUSIONS
Treatment of liver failure by PE combined with HF is safe and effective, and its efficacy is higher than PE alone.
Yang
Yong-feng
YF
The Second Hospital of Nanjing, Affiliated to Southeast University Medical School, Nanjing 210003, Jiangsu, China.
Huang
Ping
P
Zhang
Ning
N
Gai
Xiao-dong
XD
Feng
Xiao-ning
XN
Zhong
Yan-dan
YD
Wang
Li-rong
LR
Yang
Yi-jun
YJ
Zhao
Wei
W
D000328:Adult; D005260:Female; D006440:Hemofiltration; D006801:Humans; D017093:Liver Failure / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010951:Plasma Exchange; D016896:Treatment Outcome; D055815:Young Adult