血浆置换加双重血浆分子吸附对自身免疫性 肝炎合并肝衰竭的细胞因子的影响.

Objective　To study the effect of Plasma Exchange （ PE） combined with Double Plasma Molecular Absorption System （DPMAS） on cytokines in patients with autoimmune hepatitis complicated with liver failure，and to explore the significance of Plasma Exchange combined with Double Plasma Molecular absorption in immunotherapy and the impact on the prognosis of such patients. Methods　In this study， 22 patients with autoimmune hepatitis complicated with liver failure who were hospitalized in the Third People’ s Hospital of Kunming City from October 2017 to August 2020 were selected. These patients received plasma exchange combined with double plasma molecular adsorption therapy，and the changes of cytokines （IL-2，IL-4，IL-6，IL-10，TNF-α），liver function，blood ammonia，coagulation function，blood routine and other indicators before and after the combined medical treatment were analyzed. Results　After treatment，the levels of cytokines IL-2，IL-6，and TNF-α， liver function （ TBil， AST， ALT， ALB） ， blood ammonia， prothrombin activity， hemoglobin， platelet decreased significantly，（P < 0.05）；while the differences in cytokines IL-4 and IL-10），total bile acid and other indicators were statistically insignificant （P > 0.05） . Conclusion　Selective plasma exchage combined with double plasma molecular adsorption in the treatment of patients with autoimmune hepatitis complicated with liver failure helps to maintain homeostasis and supports the regeneration of liver cells，so as to restore liver function and improve clinical symptoms such as jaundice. This method can improve the survival rate of patients，improve the success rate of liver failure treatment，and is worthy of clinical promotion. [ABSTRACT FROM AUTHOR]