不同模式非生物型人工肝治疗对肝衰竭患者细胞因子水平的影响OA
Effects of Different Models of Artificial Liver Support System on Cytokine Levels in Patients with Liver Failure
目的 比较不同人工肝支持模式对肝衰竭患者细胞因子水平的调节效应.方法 回顾性纳入2022年1月至2024年1月南昌大学第一附属医院收治的140例接受人工肝治疗的肝衰竭患者.根据治疗模式分为4组:胆红素吸附(bilirubin adsorption,BA)组18例、双重血浆分子吸附系统(double plasma molecular adsorption system,DPMAS)组25例、血浆置换(plasma exchange,PE)+BA组57例及PE+DPMAS组40例.采用多重荧光微球检测法检测治疗前后多种细胞因子(包括IL-2,IL-5,IL-6和IL-8等)水平,使用配对t检验或Wilcoxon符号秩检验比较治疗前后细胞因子的水平.结果 治疗前后DPMAS组患者IL-2均数从1.87 pg/mL下降至1.37 pg/mL,(P<0.05).PE+DPMAS组IL-5均数从5.2 pg/mL 下降至3.44pg/mL,(P<0.05),IL-8从33 pg/ml 下降至30 pg/mL,(P<0.05).PE+BA与PE+DPMAS组患者IL-1β,IL-2,IL-17,IFN-γ,IFN-α水平均较治疗前下降,(P<0.05).预后恶化组患者基线IL-6水平显著高于预后良好组(P<0.05).四组人工肝治疗均改善了肝功能(P<0.05).结论 人工肝治疗可显著降低肝衰竭患者的部分细胞因子水平,组合模式对细胞因子的清除作用优于单一模式.
Objective This study aimed to compare the regulatory effects of different artificial liver support systems(ALSS)on cytokine levels in patients with liver failure.Methods A total of 140 patients with liver failure who underwent ALSS between January 2022 and January 2024 were retrospectively enrolled.Based on the therapeutic modalities,they were divided into four groups:the bili-rubin adsorption(BA)group(n=18),the dual plasma molecular adsorption system(DPMAS)group(n=25),the plasma exchange(PE)+BA group(n=57),and the PE+DPMAS group(n=40).Levels of multiple cytokines(including IL-2,IL-5,IL-6,IL-8,etc.)were measured using multiplex fluorescent microsphere immunoassays before and after treatment.Paired t-tests or Wilcoxon signed-rank tests were employed to compare cytokine levels before and after treatment.Results In the DPMAS group,the mean level of IL-2 decreased from 1.87 pg/mL to 1.37 pg/mL after treatment(P<0.05).In the PE+DPMAS group,the mean level of IL-5 decreased from 5.2 pg/mL to 3.44 pg/mL(P<0.05),and IL-8 decreased from 33 pg/mL to 30 pg/mL(P<0.05).In both the PE+BA and PE+DPMAS groups,the levels of IL-1β,IL-2,IL-17,IFN-γ,and IFN-α decreased compared to those before treatment(P<0.05).The baseline IL-6 level in the deteriorated prognosis group was significantly higher than that in the improved prognosis group(P<0.05).All four artificial liver treatment groups showed improved liver function(P<0.05).Conclusion ALSS significantly reduces certain cytokine levels in patients with liver failure,and combination modalities demonstrate superior efficacy in cytokine clearance compared to single modalities.
ZENG Yuyu;WAN Jun;LI Lei;SHI Yufei;ZHU Ying;XU Qinglang;LI Xiaopeng;WU Xiaoping
Department of Infection,First Affiliated Hospital,Nanchang University,Nanchang 330006,ChinaDepartment of Infection,First Affiliated Hospital,Nanchang University,Nanchang 330006,ChinaDepartment of Infection,First Affiliated Hospital,Nanchang University,Nanchang 330006,ChinaDepartment of Infection,First Affiliated Hospital,Nanchang University,Nanchang 330006,ChinaDepartment of Infection,First Affiliated Hospital,Nanchang University,Nanchang 330006,ChinaDepartment of Infection,First Affiliated Hospital,Nanchang University,Nanchang 330006,ChinaDepartment of Infection,First Affiliated Hospital,Nanchang University,Nanchang 330006,ChinaDepartment of Infection,First Affiliated Hospital,Nanchang University,Nanchang 330006,China
医药卫生
肝衰竭人工肝细胞因子
Liver failureArtificial liver support systemCytokines
《西南医科大学学报》 2026 (1)
26-31,6
江西省自然科学基金(20212ACB206010)北京肝胆相照公益基金会人工肝专项基金(RGGJJ-2021-032)
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