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目的:检测人工肝治疗前、后,重症乙型肝炎患者血清IL-18、总胆红素、γ-球蛋白(γG)水平的变化,分析人工肝技术清除病理性有害物质的功能。方法:34例慢性重症乙型肝炎患者分为两组,18例为人工肝治疗组,进行人工肝+内科综合治疗;16例为对照组,只进行内科综合治疗,血清IL-18、总胆红素及γG的水平,分别采用ELISA法、Beck-manCX4生化仪及Sebia电泳仪进行检测。结果:人工肝治疗组治疗前、后,血清IL-18的含量分别为(499.11±230.24)ng/L和(313.78±83.28)ng/L,差异显著(P<0.05);对照组治疗前、后血清IL-18的含量分别为(477.89±163.79)ng/L和(373.73±148.41)ng/L,差异无统计学意义(P>0.05)。人工肝治疗组治疗前、后,血清总胆红素含量的均值分别为(555.01±17.81)μmol/L和(305.92±62.19)μmol/L;差异显著(P<0.05)。血清γG均值分别为(23.8±12.41)g/L和(22.47±2.28)g/L,无统计学意义(P>0.05)。对照组治疗前、后血清总胆红素含量的均值分别为(543.12±21.77)μmol/L和(513.55±15.58)μmol/L;血清γG均值分别为(21.66±13.48)g/L和(21.96±5.88)g/L,均无统计学意义(P>0.05)。结论:人工肝技术可有效地清除重肝乙肝患者体内IL-18、总胆红素等病理性物质,提高患者的存活率,为肝移植的治疗争取了时间。
Objective: To detect the changes of serum IL-18, total bilirubin and γ-globulin (γG) levels in patients with severe hepatitis B before and after artificial liver therapy and analyze the function of artificial liver technique in removing pathological harmful substances. Methods: Thirty-four patients with chronic severe hepatitis B were divided into two groups. 18 patients were treated with artificial liver and combined with artificial medicine and internal medicine. 16 patients served as control group. Only medical treatment, serum IL-18, The levels of hRG and γG were detected by ELISA, Beck-manCX4 biochemical analyzer and Sebia electrophoresis system respectively. Results: Before and after treatment, the levels of IL-18 in serum in the treatment group were (499.11 ± 230.24) ng / L and (313.78 ± 83.28) ng / L, The serum levels of IL-18 were (477.89 ± 163.79) ng / L and (373.73 ± 148.41) ng / L, respectively, with no significant difference (P> 0.05). The mean serum total bilirubin levels in the artificial liver treatment group before and after treatment were (555.01 ± 17.81) μmol / L and (305.92 ± 62.19) μmol / L respectively, with significant differences (P <0.05). The mean serum γG levels were (23.8 ± 12.41) g / L and (22.47 ± 2.28) g / L, respectively, with no statistical significance (P> 0.05). The mean serum total bilirubin levels in the control group before and after treatment were (543.12 ± 21.77) μmol / L and (513.55 ± 15.58) μmol / L, respectively, and the serum γG mean values were 21.66 ± 13.48 g / L and 21.96 ± 5.88) g / L, no statistical significance (P> 0.05). Conclusion: Artificial liver technology can effectively remove the pathological substances such as IL-18 and total bilirubin in patients with severe hepatitis B, improve the survival rate of patients and gain time for the treatment of liver transplantation.