摘要目的为进一步探索人工肝支持系统(ALSS)治疗重型肝炎临床应用疗效,并研究其机制.方法应用ALSS共治疗235例重型肝炎患者.治疗前后检测了肝功能、内毒素含量等,并对部分患者检测血清乙型肝炎病毒(HBV)含量、氨基酸谱等.比较重型肝炎不同期应用ALSS治疗效果. 结果 108例重肝患者治疗后存活.ALSS治疗后,重型肝炎肝功能明显改善,血内毒素和HBV含量明显下降,血清蛋氨酸和芳香族氨基酸浓度下降,BCAA/AAA比值上升.早、中期重型肝炎患者应用ALSS治愈好转率远高于晚期重型肝炎患者. 结论人工肝治疗重型肝炎疗效可靠,在早、中期治疗最为适宜.

abstractsObjective　To assess the effectiveness of artificial liver support system (ALSS) treatment in patients with hepatic failure. Methods　235 cases of hepatic failure were treated with ALSS in our hospital. All data were analyzed by SPSS. The effectiveness of ALSS treatment was compared according to different stages (i.e., early, middle and end stages). Results　108 patients survived after therapy of ALSS. After each ALSS treatment, the liver function of these patients was greatly improved, the serum endotoxin and HBV-DNA concentrations were significantly decreased, and the serum concentration of aromatic amino acids (AAA) such as methionine decreased while the ratio of branched chain amino acids and aromatic amino acids (BCAA/AAA ratio) increased; patients treated with ALSS in the early or middle stages of disease had much higher survival rates than patients in the end stage of disease.Conclusion　ALSS is a reliable therapy for advanced liver diseases and treatment at early or middle stages is appropriate.