【作者】 罗红涛； 刘全妹； 张沛华； 罗月华； 罗钻弟； 叶一农； 吴敏； 周立新；

【Author】 Luo Hong-Tao~1 Liu Quan-Mei~1 Zhang Pei-Hua~1 Luo Yue-Hua~1 Luo Zhuan-Di~1 Ye Yi-Nong~1 Wu Min~2 Zhou Li-Xin~2 ~1 Department of Infectious Diseases, ~2 ICU & Blood Purification Center,the First People’s Hospital of Foshan,Guangdong,P.R.China 528000

【机构】 广东佛山市第一人民医院感染科； ICU&血液净化中心；

【摘要】 背景:分子吸附循环系统(Molecular Adsorbents Recirculating System,MARS)是一种新型的先进人工肝,本研究的目的是评价 MARS 对各种原因导致的多脏器功能障碍(MODS)病人的临床治疗效果。方法:42例(27M/15F)各种原因导致的多脏衰病人进行了110次6-24小时的 MARS 治疗。结果:MARS 治疗使 NO 和相关炎症细胞因子 TNF-α,IL-2,IL-6,IL-8,和 LBP 明显下降,同时大量水溶性和非水溶性毒素也被明显清除,病人临床症状得到明显改善,包括脑水肿,血流动力学,肾功能和呼吸功能,这使得总体 SOFA(Sequential Organ Failure Assessment)评分得到明显下降,总体预后得到改善:18例痊愈出院,总体生存率42.9%。结论:我们认为 MARS 可以安全有效地应用于各种原因导致的 MODS 病人,有效清除 NO 和炎症因子,防治 SIRS,改善临床预后。更多还原

【Abstract】 Background:Molecular Adsorbents Recirculating System(MARS)is a new promising artificial liver support therapy,the aim of this study was to assess the effectiveness of MARS to remove nitro oxide(NO) and cytokines in multiple organ dysfunction syndrome(MODS)with severe liver failure patients.Methods:110 single MARS treatments were performed with length of 6-24 hours on 42 MODS patients(27M/15F).Results: The MARS therapy was associated with a significant removal of NO and certain cytokines such as TNF-α,IL-2, IL-6,IL-8,and LBP,together with marked reduction of other non-water soluble albumin bound toxins and water soluble toxins,these were associated with a improvement of the patients’ clinical conditions including hydrocephalus,deranged hemodynamic situation and as well as renal and respiratory function,thus resulted into marked decrease of Sequential Organ Failure Assessment(SOFA)score and improved outcome:16 patients were able to be discharged from the hospital,the overall survival of 42 patients was 42.9%.Conclusion:We can confirm the positive therapeutic impact and safety to use MARS on various pathogenic MODS patients associated with elevated levels of NO and cytokines.更多还原