title: [Comparison of curative effect of low flow rate plasma exchange combined with hemofiltration for treatment of liver failure].
abstract: 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.
authors.affiliation: The Second Hospital of Nanjing, Affiliated to Southeast University Medical School, Nanjing 210003, Jiangsu, China.
authors.forename: Yong-feng
authors.initials: YF
authors.lastname: Yang
authors.forename: Ping
authors.initials: P
authors.lastname: Huang
authors.forename: Ning
authors.initials: N
authors.lastname: Zhang
authors.forename: Xiao-dong
authors.initials: XD
authors.lastname: Gai
authors.forename: Xiao-ning
authors.initials: XN
authors.lastname: Feng
authors.forename: Yan-dan
authors.initials: YD
authors.lastname: Zhong
authors.forename: Li-rong
authors.initials: LR
authors.lastname: Wang
authors.forename: Yi-jun
authors.initials: YJ
authors.lastname: Yang
authors.forename: Wei
authors.initials: W
authors.lastname: Zhao
mesh_terms: 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