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目的探讨大剂量HBsAb阳性血浆,用于人工肝血浆置换的疗效及安全性。方法选择HBsAb阳性血浆,并尽量选择同时HBeAb和HBcAb阳性的血浆,进行肝衰竭人工肝单纯血浆置换的治疗。每次3 000ml血浆置换量。观察治疗组和对照组HBsAg和HBeAg的血清学转换率,12月时的生存率及HBV-DNA的阴转率。结果置换前后两组临床症状及肝功能的变化无统计学差异;而12月时,HBsAg和HBeAg的血清学置换率有非常显著性差异。两组的生存率也有非常显著差异,且不良反应没有统计学差异。结论大剂量HBsAb阳性血浆,用于单纯血浆置换治疗肝衰竭时,HBsAg和HBeAg血清学转率明显提高,生存率明显提高,并且是安全的。
Objective To investigate the efficacy and safety of high-dose HBsAb-positive plasma for artificial liver plasma exchange. Methods HBsAb-positive plasma was selected, and HBeAb and HBcAb-positive plasma were selected as far as possible for the treatment of hepatic failure with artificial liver pure plasma exchange. Each 3000ml plasma exchange volume. The seroconversion rates of HBsAg and HBeAg in treatment group and control group were observed, the survival rate in December and the negative conversion rate of HBV-DNA were observed. Results There was no significant difference in clinical symptoms and liver function between the two groups before and after the replacement. However, the serological replacement rates of HBsAg and HBeAg in December were significantly different. There was also a significant difference in survival rates between the two groups with no statistically significant difference in adverse reactions. Conclusions High-dose HBsAb-positive plasma, when used for pure plasma exchange in the treatment of liver failure, significantly increases the seroconversion rates of HBsAg and HBeAg, and significantly improves the survival rate and is safe.