[Analysis of prognostic factors of severe jaundice patients using HB-H-6 resin plasma perfusion].
OBJECTIVE
To investigate the influencing factors of efficacy of plasma perfusion in patients with severe jaundice.


METHODS
The clinical data of 78 patients with severe jaundice due to different causes receiving HB-H-6 resin plasma perfusion therapy admitted to Tianjin Third Central Hospital from October 2006 to July 2010 were retrospectively analyzed. Patients were divided into improved group (n = 51) and ineffective group (n = 27) according to outcomes. The effecting factors of prognosis, including age, sex, hospital stay days, number of perfusion therapy received, Child-Pugh scores before perfusion, total bilirubin (TBil) levels before perfusion, and mean TBil rebound rate were studied by univariate and multivariate logistic regression analysis.


RESULTS
All 78 patients received (3.31 ± 1.36) times of HB-H-6 resin plasma perfusion treatment. Child-Pugh score before perfusion, TBil (μmol/L) before perfusion and mean TBil rebound rate in improved group were significantly lower than those in ineffective group [Child-Pugh score before perfusion: 8.06 ± 1.01 vs. 9.44 ± 1.19; TBil before perfusion: 384.29 ± 170.41 vs. 504.93 ± 206.88; mean TBil rebound rate: -(7.35 ± 20.76)% vs. (37.32 ± 23.22)%]. They were also significantly different in gender between two groups (improved group: 30 males, 21 females; ineffective group: 24 males, 3 females, P < 0.05 or P < 0.01). Gender and mean TBil bounce rate were defined as independent significant factors influencing the clinical results by multivariate logistic regression analysis. Regression coefficient β were 5.35 and -2.82 for gender and mean TBil bounce rate respectively [χ (2) = 64.42, P = 0.000]. Receive operating characteristic curve (ROC curve) analysis showed that the area under the curve (AUC) was 0.90 (0.82, 0.97), and mean TBil bounce rate higher than 29.5% indicated poor prognosis. No obvious side effects were observed after plasma perfusion.


CONCLUSIONS
Gender and mean TBil bounce rate were independent risk factors in treatment of severe jaundice with HB-H-6 resin plasma perfusion. Mean TBil bounce rate higher than 29.5% indicated a poor prognosis.
Department of Gastroenterology and Hepatology, Tianjin Third Central Hospital, Tianjin 300170, China. huilingxiang@163.com
Hui-ling
HL
Xiang
Tao
T
Han
Zhi
Z
Du
Tao
T
Li
Jun
J
Li
Hong-min
HM
Lü
Ting-hong
TH
Li
Jia-mei
JM
Zhou
Fei
F
Tang
D000328:Adult; D005260:Female; D006801:Humans; D007565:Jaundice / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010951:Plasma Exchange / Q000379:methods*; D011379:Prognosis; D012117:Resins, Synthetic / Q000627:therapeutic use*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D016896:Treatment Outcome
D012117:Resins, Synthetic