Control study on the immediate effect and adverse reaction of different types of artificial liver treatment of liver failure

Objective To investigate the therapeutic effects and side effects of different types of artificial liver treatments of liver failure by a prospective,large-sample comparative study.Methods 469 patients from Beijing Youan hospital with liver failure or severe hepatitis whose PTA less than 50% were treated by all kinds of artificial liver treatment for 1257 times.They were divided into three groups: plasma exchange(PE) group,molecular adsorbent recirculating system(MARS) group and plasma exchange plus continuous vein-vein hemofiltration(PE+CVVH) group.The clinical symptoms,laboratory tests and adverse reactions before and after the treatments were recorded.Results The total bilirubin level is significantly decreased after treatments in the three groups.The creatinine level in MARS group and PE+CVVH group also declined dramatically.The bilirubin reduction and prothrombin activity improving in PE group and PE+CVVH group are more remarkable than that in MARS group.The decline of creatinine in PE+CVVH group and in MARS group is more remarkable than that in PE group.In PE group,the stage of hepatic encephalopathy is not modified after treatment,while in MARS group and PE+CVVH group,hepatic encephalopathy is relieved.The effective percentage is 51.5%(17/33)in MARS group and 54.3%(19/35)in PE+CVVH group.The incidence rate of adverse reaction in PE group,MARS group and PE+CVVH group is 17.6%、13.4% and 27.3% respectively.Conclusion Three types of artificial liver treatments are all effective to treat liver failure.The decline of bilirubin in PE group and PE+CVVH group is more remarkable than that in MARS group.The decline of creatinine in MARS group and PE+CVVH group is more remarkable than that in PE group.The incidence rate of anaphylactic reaction in PE group is higher than that in PE+CVVH group and MARS group.The incidence rate of fall of blood pressure in PE+CVVH group is higher than that in PE group and MARS group.The result will be helpful for doctors to choose most suitable artificial liver treatment for patients.