Abstract
OBJECTIVE: In this retrospective study, the short-term efficacy of the plasma exchange-based artificial liver support system (PE-ALSS) for chronic severe hepatitis B (CSHB) was explored. METHODS: We selected 111 CSHB patients and divided them into control (53 cases with conventional treatment) and research (58 cases with conventional treatment+PE-ALSS) groups based on the treatment they received. We then conducted inter-group comparisons regarding therapeutic effectiveness, complications, hepatic function indicators (alanine aminotransferase [ALT], aspartate aminotransferase [AST], total bilirubin [TBIL]), hepatic fibrosis markers (hyaluronic acid [HA], laminin [LN], type IV collagen [IV-C]), serum biochemical indices (interleukin [IL]-18, intercellular adhesion molecule-1 [ICAM-1]), coagulation function indices (prothrombin time [PT], thrombin time [TT], activated partial thromboplastin time [APTT]), and inflammatory factors (procalcitonin [PCT], IL-6). Finally, efficacy-associated determinants were identified by univariate and multivariate analysis. RESULTS: The research group had a superior total effective rate (94.83% vs. 69.81%, P < 0.001) and a lower complication rate (1.72% vs. 13.21%, P < 0.001) than the control group. Post-treatment, the research group exhibited statistically lower ALT (65.59±14.21 U/L vs. 89.47±17.44 U/L), AST (78.12±19.63 U/L vs. 94.91±22.27 U/L), TBIL (24.45±5.46 μmol/L vs. 45.77±7.43 μmol/L), HA (84.83±7.00 ng/mL vs. 100.47±10.41 ng/mL), LN (69.90±8.18 ng/mL vs. 80.81±8.71 ng/mL), IV-C (76.21±5.52 ng/mL vs. 85.21±7.97 ng/mL), IL-18 (343.34±108.3 pg/mL vs. 543.92±138.18 pg/mL), ICAM-1 (282.57±128.8 μg/L vs. 406.3±158.26 μg/L), PT (13.79±4.03 s vs. 15.68±3.15 s), TT (17.97±2.91 s vs. 20.11±2.23 s), APTT (35.79±11.08 s vs. 40.06±8.09 s), PCT (2.25±0.91 μg/L vs. 3.24±1.15 μg/L), and IL-6 (46.33±10.21 pg/mL vs. 50.75±11.11 pg/mL) than controls. Moreover, treatment modality (B = -1.865, odds ratio = 0.155, 95% confidence interval: 0.038-0.628) was an independent determinant of efficacy (P=0.009). CONCLUSION: PE-ALSS has significant short-term efficacy for CSHB patients.