Effects of DPMAS Combined with Plasma Exchange on Biochemical Indicators,Coagulation Function,and Prognosis in Patients with HBV～Related Acute on Chronic Liver Failure

XU Jingjing; WANG Qianqian; LI Yuqiong; DONG Yucun; XU Congcui

doi:10.13919/j.issn.2095-6274.ZHJY202507010

Abstract：Objective To explore the effects of double plasma molecular adsorption system(DPMAS)com-bined with plasma exchange(PE)on biochemical indicators,coagulation function and prognosis in patients with hepatitis B virus(HBV)related acute on chronic liver failure(ACLF,referred to as HBV-ACLF),so as to provide reference for optimizing clinical treatment regimens for HBV-ACLF.Methods A retrospective analysis was per-formed on the clinical data of 86 HBV-ACLF patients admitted to our hospital from December 2023 to March 2025.The patients were divided into two groups according to different treatment regimens.The control group(43 cases)received PE alone,while the observation group(43 cases)received DPMAS combined with PE.Biochemical indi-cators and coagulation function[prothrombin time(PT),activated partial thromboplastin time(APTT),international normalized ratio(INR)and fibrinogen(FIB)]before and after treatment were compared between the two groups.The incidence of complications and 3～month follow～up survival rate were also statistically analyzed.Results Af-ter treatment,the levels of biochemical indicators in both groups were lower than those before treatment,and the observation group had lower levels than the control group(P<0.05).After treatment,the levels of PT,INR and APTT in the observation group were higher than those in the control group,while the level of FIB was lower than that in the control group(P<0.05).There was no significant difference in the incidence of complications such as hepatorenal syndrome,pulmonary infection,electrolyte disturbance and abdominal infection between the two groups(P>0.05).After 3 months of follow～up,the survival rate of the observation group was higher than that of the control group(P<0.05).Conclusion For HBV-ACLF patients,DPMAS combined with PE treatment can more efficiently remove inflammatory factors and endotoxins in the body,which is conducive to improving liver function and increasing the 3～month survival rate of patients with good safety.However,the effect of this combined treatment regimen in improving coagulation function is not as good as that of PE alone,so comprehensive consider-ation of patients'coagulation function status is required in clinical application.