国产BS330胆红素吸附柱治疗高胆红素血症患者的临床观察

肾脏病与透析肾移植杂志 ›› 2014, Vol. 23 ›› Issue (3): 229-234.

国产BS330胆红素吸附柱治疗高胆红素血症患者的临床观察

出版日期:2014-06-28 发布日期:2014-07-02

Treatment of hyperbilirubinemia using a new bilirubin absorber-BR330

Online:2014-06-28 Published:2014-07-02

摘要/Abstract

摘要：

目的：观察国产胆红素吸附柱BS330治疗高胆红素血症的疗效与安全性，并与国际通用的胆红素吸附柱BRS350进行对比。方法：选取10例高胆红素血症患者，5例患者采用BS330行组合式CVVH-胆红素吸附，另5例患者采用BRS350行组合式CVVH-胆红素吸附。两组患者血流量200～220 ml/min，血浆分离速度90ml /min；分离血浆成分经CVVH 血滤器( AV600) 滤过，超滤率66 ml /min，浓缩血浆成分再经胆红素吸附柱吸附后回输体内。同时应用前稀释方式在EC40W血浆成分分离器前输入碳酸氢盐置换液(4000 ml/h)。治疗时间均为8h。治疗中检测治疗前、后血生化和凝血四项，记录患者临床生命体征。结果：BRS350组单次治疗后总胆红素（TBL），直接胆红素（DBL），间接胆红素（IDBL），总胆汁酸（TBA）下降率分别为（54.4±7.0）%，（56.7±7.1）%，（37.6±27.1）%，（35.0±5.1）%；BR330组TBL，DBL，IDBL，TBA下降率分别为（42.9±11.8）%，（44.6±13.0）%，（35.8±11.0）%，（32.4±12.9）%。两组患者对比TBL，DBL，IDBL，TBA下降率均无统计学差异（P>0.05）。两组患者总蛋白(TP)，白蛋白(ALB)，活化的部分凝血活酶时间( APTT)，凝血酶原时间(PT)，国际标准化比值(INR)治疗前后均无明显变化，患者生命体征平稳，无不良事件发生。结论：国产的胆红素吸附柱BS330，可显著降低患者胆红素水平，改善生化检查指标且患者耐受性好，与国际通用的胆红素吸附柱相比其疗效及安全性都无明显差异，值得临床推广应用。

关键词: 高胆红素血症, 人工肝支持系统, 胆红素吸附, 血液滤过

Abstract:

ABSTRACT Objective: To observe the clinical efficacy and safety of a Chinese bilirubin absorber-BR330 and compare to the bilirubin absorber-BRS350． Methodology: Ten cases with hyperbilirubinemia received combined CVVH-bilirubin adsorption were enrolled into this study．Five of them were treated with BS330 and other of them were treated with BRS350．The rate of blood flow was set at 200～220 ml /min and the rate of plasma separated was set at 90 ml /min．Separated blood plasma components were filtrated by the CVVH filter AV600 when ultrafiltration rate was set at 66 ml /min．Then concentrated plasma components were adsorpted by bilirubin adsorption column and they were reinfusioned in vivo．At the same time bicarbonate replacement fluid at the speed of 4000 ml /hr with pre-dilution mode was input before plasma component separator EC40W．The treatment was performed with 8 hours．Blood biochemistry and coagulation were measured before and after single treatment．The clinical vital signs were recorded．Results: The average reduction rate of TBL, DBL, IDBL, and TBA were 54.4±7.0%, 56.7±7.1%, 37.6±27.1% and 35.0±5.1% in BRS350 group, respectively, with the BS330 group after single treatment and the reduction rate of TBL, DBL, IDBL, and TBA were 42.9±11.8）%，（44.6±13.0）%, （35.8±11.0）% and（32.4±12.9）%. There is no significant difference. There were no effect on total protein(TP), albumin (ALB) and coagulation with two groups after single treatment．During the treatment，the vital signs of all patients were stable and there were no adverse events． Conclusion: The Chinese bilirubin absorber-BR330 is a effective bilirubin adsorption column．It can significantly reduce bilirubin levels．Moreover it is well tolerated for patients and there were no effect on serum albumin and coagulation．

Key words: hyperbilirubinemia, artificial liver support bilirubin, adsorption hemofiltration

何群鹏|龚德华|邬步云|等. 国产BS330胆红素吸附柱治疗高胆红素血症患者的临床观察[J]. 肾脏病与透析肾移植杂志, 2014, 23(3): 229-234.

HE Qunpeng|GONG Dehua|WU Buyun|et al. Treatment of hyperbilirubinemia using a new bilirubin absorber-BR330[J]. Chinese Journal of Nephrology, Dialysis & Transplantation, 2014, 23(3): 229-234.

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