• 昆明醫(yī)學(xué)院第二附屬醫(yī)院肝膽外科（昆明650101）;

【摘要】目的 評價人工肝支持系統(tǒng)（ALSS）在肝衰竭和肝臟移植中的作用。
方法 對44例肝衰竭患者(包括12例行肝移植者)進行分子吸附循環(huán)系統(tǒng)（MARS）或血漿置換治療，檢測治療前、后各種有毒物質(zhì)及細(xì)胞因子等的改變并進行比較。
結(jié)果 44例肝衰竭患者，經(jīng)ALSS治療后臨床癥狀及體征明顯改善； 血總膽紅素、總膽汁酸、谷丙轉(zhuǎn)氨酶、肌酐、尿素氮、血氨及內(nèi)毒素水平明顯降低（P＜0.05）； 血清NO和TNF-α、IL-4、IL-6水平亦明顯降低（P＜0.05）； 治療前、后紅細(xì)胞、白細(xì)胞、血小板無明顯變化（P gt;0.05）。30例重型乙肝肝衰竭患者存活18例，存活率為60.0%； 6例肝臟移植術(shù)前急性肝衰竭患者均成功接受肝臟移植； 6例肝臟移植術(shù)后急性肝衰竭患者存活2例； 2例胰十二指腸切除術(shù)后急性肝衰竭者，死亡1例。
結(jié)論 ALSS通過全面清除肝衰竭患者體內(nèi)毒素、NO和細(xì)胞因子，對肝衰竭有肯定的治療作用； 并對等待肝臟移植的肝衰竭患者發(fā)揮過渡性橋梁作用。

引用本文： 阿永俊,李立,李曉延,唐繼紅,魏曉平,陳剛,朱洪. 人工肝支持系統(tǒng)在肝衰竭和肝臟移植中的臨床應(yīng)用研究. 中國普外基礎(chǔ)與臨床雜志, 2005, 12(5): 496-498. doi: 復(fù)制

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3. Mitzner SR, Stange J, Klammt S, et al. Albumin dialysis using the molecular adsorbent recirculating system [Ｊ]. Curr Opin Nephrol Hypertens, 2001; 10(6)∶777.
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7. Sorkine P, Ben A braham R, Szold O, et al. Role of the molecular adsorbents recycling system(MARS) in the treatment of patients with acuteonchronic liver failure [Ｊ]. Liver Transplant, 2001; 7(2)∶1034.
8. Jalan R, Williams R. Acuteonchronic liver failure: pathophysiological basis of therapeutic options [Ｊ]. Blood Purif， 2002; 20(3)∶252.
9. Mitzner SR, Stange J, Klammt S, et al. Extracorporeal detoxification using the molecular adsorbent recirculating system for critically ill patients with liver failure [Ｊ]. J Am Soc Nephrol, 2001; 12(Suppl 17)∶S75.
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  1. 1. Bathgate AJ, Garden OJ, Forsythe JR, et al. The outcome of the first 165 orthotopic liver transplants in Scotland [Ｊ]. Scott Med J, 1999; 44(1)∶ 9.
  2. 2. Stange J, Mitzner S, Klammt S, et al. New extracorporeal liver support for chronic liver disease complicated by cholestasisresults of a prospective controlled randomized two center trial [Ｊ]. J Hepatol, 2001; 34(Supple 1)∶45A1289.
  3. 3. Mitzner SR, Stange J, Klammt S, et al. Albumin dialysis using the molecular adsorbent recirculating system [Ｊ]. Curr Opin Nephrol Hypertens, 2001; 10(6)∶777.
  4. 4. 李蘭娟，楊芊，黃建榮，等. 人工肝支持系統(tǒng)治療重癥肝炎的應(yīng)用研究 [Ｊ]. 中華傳染病雜志， 2001； 114（9）∶941.
  5. 5. 中華醫(yī)學(xué)會傳染病與寄生蟲病學(xué)分會肝病學(xué)分會. 病毒性肝炎防治方案 [Ｊ]. 中華肝臟病雜志， 2000； 8（6）∶324.
  6. 6. Palmes D, Qayumi AK, Spiegel HU. Liver bridging techniques in the treatment of acute liver failure [Ｊ]. J Invest Surg, 2000; 13(6)∶299.
  7. 7. Sorkine P, Ben A braham R, Szold O, et al. Role of the molecular adsorbents recycling system(MARS) in the treatment of patients with acuteonchronic liver failure [Ｊ]. Liver Transplant, 2001; 7(2)∶1034.
  8. 8. Jalan R, Williams R. Acuteonchronic liver failure: pathophysiological basis of therapeutic options [Ｊ]. Blood Purif， 2002; 20(3)∶252.
  9. 9. Mitzner SR, Stange J, Klammt S, et al. Extracorporeal detoxification using the molecular adsorbent recirculating system for critically ill patients with liver failure [Ｊ]. J Am Soc Nephrol, 2001; 12(Suppl 17)∶S75.
  10. 10. Vincent JL, Moreno R, Takala J, et al. The SOFA (Sepsisrelated Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on SepsisRelated Problems of the European Society of Intensive Care Medicine [Ｊ]. Intensive Care Med, 1996; 22(7)∶707.