【摘要】 目的 评估血浆置换（PE）及双重血浆分子吸附系统（DPMAS）治疗原发性胆汁性胆管炎（PBC）患者的临床疗效及对预后的影响。方法 回顾性分析自2013年12月至2022年1月于昆明医科大学第二附属医院就诊的526例PBC患者临床资料，按照治疗方式不同分组，并进行倾向性匹配。对比两组患者治疗前后临床症状、实验室指标及MELD评分变化，评价人工肝治疗PBC患者的临床疗效，通过对比两组患者3、6、12个月累计生存率，评估人工肝治疗对PBC患者生存结局的影响。结果 观察组有效率高于对照组，差异有统计学意义（76.7%vs. 55.8%，χ2=4.214,P=0.040）。Cox比例风险回归分析显示TBIL为影响PBC患者3、6、12个月生存率的独立危险因素。结论 人工肝支持系统治疗能有效缓解PBC患者临床症状，能降低ALT、AST、TBIL，改善患者凝血功能，降低MELD评分，对PBC患者3、6、12个月的生存结局有改善趋势。更多还原

【Abstract】 Objective To evaluate the clinical efficacy of plasma exchange(PE) and double plasma molecular absorption system(DPMAS) in the treatment of primary biliary cholangitis(PBC) and the effect of this therapy on prognosis. Methods The clinical data on 526 PBC patients in our hospital from December 2013 to January 2022 were retrospectively analyzed. The patients were divided into different groups according to different therapies and then matched with propensity. The changes in symptoms, laboratory indexes and MELD scores were compared between two groups before and after treatment, and the clinical efficacy of artificial liver treatment for PBC patients was assessed. The effect of this treatment on the survival outcomes in these patients via comparing the cumulative survival rates at 3, 6 and 12 months between the two groups. Results The efficiency was better in the group with artificial liver treatment in addition medical therapy than the group with medical treatment alone, the difference was statistically significant(76.7% vs. 55.8%, χ2 = 4.214, and P = 0.040). Cox proportional risk regression showed that TBIL was an independent risk factor affecting the 3-, 6-, or 12-month survival in PBC patients. Conclusions Artificial liver support system can effectively relieve symptoms, reduce levels of ALT, AST and TBIL, improve blood coagulation function, and lower MELD scores in PBC patients. This therapy revealed a trend of improvement in 3-, 6-, or 12-month survival outcomes.更多还原