中华肝脏病杂志最新文献

{"title":"[Fibroblast growth factor 21 improves alcoholic liver disease by regulating gut microbiota in mice].","authors":"G C Wu, X Miao, W J Zhang, X An, L N Xia, C W Tang","doi":"10.3760/cma.j.cn501113-20260318-00116","DOIUrl":"10.3760/cma.j.cn501113-20260318-00116","url":null,"abstract":"<p><p><b>Objective:</b> To investigate whether fibroblast growth factor 21 (FGF21) can improve alcoholic liver disease (ALD) by regulating gut microbiota. <b>Methods:</b> Male C57BL/6J wild-type (WTPF) and Fgf21^-/- (KO) mice were used and divided into control groups (fed with a control liquid diet), ALD model groups (fed with an ethanol-containing liquid diet for 8 weeks), and rhFGF21 treatment groups (administered intraperitoneal injections of rhFGF21 4 mg·kg^-1·day^-1 for 5 days before the end of ALD modeling), totaling six groups. Gut microbiota was analyzed using 16S rRNA sequencing to detect liver histopathology and serum lipopolysaccharide (LPS) levels. Statistical analysis was performed using one-way ANOVA or the Kruskal-Wallis test. <b>Results:</b> The KOPF group showed more severe liver damage and higher triglyceride accumulation compared to the WTPF group under ethanol exposure. Exogenous rhFGF21 administration significantly reduced intracellular liver triglyceride content and degree of liver injury in WTPF and KOPF groups (<i>P</i><0.05). Gut microbiota analysis showed that FGF21 significantly altered gut microbiota β-diversity in mice (adjusted <i>P</i><0.05). The WTAF and KOAF groups had a lower abundance of Firmicutes compared to the control group, while the abundance of <i>Proteobacteria</i>, <i>Bacteroidetes</i>, and serum LPS levels was increased. The abundance of <i>Proteobacteria</i>, <i>Bacteroidetes</i>, and serum LPS levels decreased again, while the firmicutes abundance was restored following rhFGF21 administration (<i>P</i><0.05). <b>Conclusion:</b> FGF21 deficiency worsens gut microbiota dysbiosis in ALD mice, while exogenous rhFGF21 supplementation regulates gut microbiota, lowers serum LPS, and improves ALD.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 8","pages":"748-756"},"PeriodicalIF":0.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Emphasizing the precise application of emergency endoscopy in the treatment of portal hypertensive bleeding in cirrhosis].","authors":"B M Wang, L Zhou, Y Jing","doi":"10.3760/cma.j.cn501113-20260525-00203","DOIUrl":"10.3760/cma.j.cn501113-20260525-00203","url":null,"abstract":"<p><p>Acute esophagogastric variceal bleeding due to portal hypertension is one of the most severe complications of cirrhosis, with a high mortality rate. Emergency endoscopy holds a core, central role in the diagnosis and treatment of AEVB, not only identifying the source of bleeding and implementing hemostatic interventions but also simultaneously serving as an important basis for subsequent hierarchical management and comprehensive treatment decisions. Increasing evidence shows that 12-24 hours, under the premise of drug therapy after bleeding, is a reasonable time window for endoscopic treatment. Meanwhile, the selection of airway protection, rebleeding risk assessment, and the connection between endoscopic technology and interventions and surgery are important aspects of precise emergency endoscopic treatment. Emergency endoscopic treatment of AEVB has changed from a \"time-oriented\" to a \"risk stratification-oriented\" approach and gradually shifted from a single technical operation to precise and individualized decision-making. Herein, the precise application of emergency endoscopy for AEVB is systematically summarized in combination with the latest research progress and guidelines so as to provide reference for clinical decision-making.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 7","pages":"613-617"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13416775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[APASL clinical practice guidelines on the management of chronic hepatitis B infection: a 2026 update].","authors":"H You, Rakhi Maiwall, J Chen, H O O N Ahn, Kadir Dokmeci, X G Dou, Manal El-Sayed, J G Fan, Rino Gani, Z L Gao, Jacob George, Hasmik Ghazinian, George Goh, Saeed Hamid, J L Hou, S Q Huang, D Ji, J D Jia, Tatsuo Kanda, J H Kao, Yoon Jun Kim, R I N A L D I A Lesmana, Rosmawati Mohamed, Q Ning, Necati Ormeci, Motoyuki Otsuka, Diana Payawal, T H A N H Thuy, Keo Sailey, K U M A R Sharma, D Sollano, J Sun, Tawesak Tanwandee, Alexander Thompson, F S Wang, G Q Wang, L Wei, L L Wong, W S Wong, Y J Yeoh, Z F Yip, M L Yu, W H Zhang, H Zhuang, Q L Lai, Masao Omata, K U M A R Sarin, J J Lau","doi":"10.3760/cma.j.cn501113-20260416-00155","DOIUrl":"10.3760/cma.j.cn501113-20260416-00155","url":null,"abstract":"<p><p>Globally, especially in the Asia-Pacific region, chronic hepatitis B infection has led to an undesirable escalating morbidity and mortality with acute-on chronic liver failure, end-staged liver cirrhosis and hepatocellular carcinoma. This has happened despite the past four-decades of major scientific advances made in screening methods, vaccination strategies, highly effective low-cost anti-viral therapies and surveillance strategies for early detection of hepatocellular carcinoma. To address this health threat, APASL has formed a Viral Elimination Taskforce to unite key opinion leaders from its member countries and regions. The ongoing shifts in hepatitis B epidemiology, socioeconomic changes, and advancements in technology are taken into consideration. With the conjoint efforts of all the members of the APASL Viral Elimination Taskforce, these clinical practice guidelines have been formulated aiming to facilitate healthcare professionals, policy makers and patients in making practical and cost-effective management decisions for chronic hepatitis B infection. Altogether, it provides recommendations in thirteen major areas related to screening, vaccination, treatment and HCC surveillance. The implementation of these clinical practice guidelines represents major APASL effort toward elimination of the disease burden due to chronic hepatitis B infection in Asia-Pacific region.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 7","pages":"640-667"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13423731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Medical treatment of portal hypertensive bleeding in cirrhosis].","authors":"L H Zheng, X M Zhou","doi":"10.3760/cma.j.cn501113-20260512-00186","DOIUrl":"10.3760/cma.j.cn501113-20260512-00186","url":null,"abstract":"<p><p>Cirrhosis can cause elevated portal vein pressure and the opening of collateral circulation, leading to portal hypertension. Esophagogastric variceal rupture and bleeding are the most urgent clinical manifestations of cirrhotic portal hypertension and have a high mortality rate. Therefore, comprehensive management of cirrhotic portal hypertension, including screening, prevention, and treatment of bleeding, is crucially significant for improving the survival rate and quality of life of patients. Herein, we discuss the medical treatment of portal hypertensive bleeding in cirrhosis.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 7","pages":"630-634"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13416778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysis of the efficacy and safety profile of the use of eltrombopag ethanolamine tablets in patients with cirrhotic thrombocytopenia].","authors":"H B Ning, H M Jin, K Li, Z Peng, J Shang","doi":"10.3760/cma.j.cn501113-20251027-00457","DOIUrl":"10.3760/cma.j.cn501113-20251027-00457","url":null,"abstract":"<p><p><b>Objective:</b> To investigate and analyze the efficacy and safety profile data on the use of eltrombopag drugs in patients with cirrhotic thrombocytopenia scheduled for invasive procedures. <b>Methods:</b> A retrospective analysis was conducted on 51 cases with cirrhotic thrombocytopenia who visited Henan Provincial People's Hospital from May 2024 to May 2025 and were scheduled for invasive procedures. Eltrombopag was used at a dosage of 25 mg/day for one week. Platelet count (PLT) levels, coagulation function parameters [prothrombin time (PT), fibrinogen (FIB)], and liver function parameters [alanine aminotransferase (ALT), total bilirubin (TBil), etc.] were evaluated at baseline and one week following drug usage. The efficacy and safety profile of eltrombopag were analyzed and grouped by PLT level, liver function (ALT, TBil) as either normal or abnormal, and presence or absence of combined hepatocellular carcinoma. The effectiveness of drug treatment was evaluated by the elevation of PLT count above 75×10⁹/L to meet the criteria for invasive procedures. Two independent samples <i>t</i>-tests or ANOVA were used to compare continuous data between groups. Categorical data were compared using <i>χ</i>² tests between groups. <b>Results:</b> Of the 51 cases, 39 were male and 12 were female, with a mean age of (54.24±12.34) years and a baseline platelet count (PLT) of (41.12±13.71)×10⁹/L. 46 cases (90.2%) had elevated PLT, with an average of (82.61±35.49) ×10⁹/L (<i>P</i><0.001) following use of one week eltrombopag therapy. The treatment efficacy rate was 64.7% (33/51) with an increase of PLT to 75×10⁹/L post-treatment. FIB and ALT decreased compared to baseline (<i>P</i><0.05) following one week of treatment, while there were no statistically significant differences in PT, AST, and TBil before and after treatment (<i>P</i>>0.05). There were no statistically significant differences in any indicators or treatment efficacy rates among subgroups (<i>P</i>>0.05). There were no statistically significant differences in changes in coagulation and liver function parameters (<i>P</i>>0.05). <b>Conclusion:</b> A one-week eltrombopag therapy use can significantly increase platelet count levels with a favorable safety profile in patients with cirrhotic thrombocytopenia. Furthermore, baseline platelet count levels and liver function parameters, and the presence or absence of hepatocellular carcinoma may not affect therapy efficacy.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 7","pages":"668-674"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13416777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Advancement in the role of exosomes for hepatitis B virus infection diagnosis and treatment: mechanisms and clinical applications].","authors":"M X Du, W T Hua, S H Wan, Y T Gao, Y L Zhang, J Y Liu, X Zhang","doi":"10.3760/cma.j.cn501113-20251030-00466","DOIUrl":"10.3760/cma.j.cn501113-20251030-00466","url":null,"abstract":"<p><p>Hepatitis B virus (HBV) infection is a major global public health problem, causing approximately one million deaths annually. Exosomes are nanosized vesicles (30-150 nm) enclosed in a lipid bilayer membrane, secreted by almost all cells, and carry bioactive substances such as proteins, nucleic acids, and lipids, thereby playing a key role in intercellular communication. Recent research results have shown that exosomes play an important advanced role in the diagnosis and treatment of HBV infection. This review systematically summarizes the dual role of exosomes in HBV infection (promoting viral transmission and participating in immune regulation), their application as novel biomarkers in the diagnosis of HBV-related liver diseases, the latest research progress in exosome-based therapeutic strategies, and their current status in clinical translation, with the aim of providing updated and more precise biological markers and therapeutic targets for clinical diagnosis and treatment and offering perspectives for future research directions.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 7","pages":"708-714"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13416776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Novel targets and drugs for the treatment of portal hypertension in liver cirrhosis].","authors":"C P Zhu, W F Xie","doi":"10.3760/cma.j.cn501113-20260513-00188","DOIUrl":"10.3760/cma.j.cn501113-20260513-00188","url":null,"abstract":"<p><p>Portal hypertension in liver cirrhosis is a key factor driving decompensation and mortality, and pharmacological therapy has been the cornerstone of treatment. Although traditional medications, mainly non-selective β-receptor blockers, have played an important role in preventing decompensated events such as variceal bleeding, there still exist difficulties such as low response rates and high side effects, which complicate meeting the treatment requirements. In recent years, with the deepening understanding of the disease, drug intervention is shifting from simply reducing portal blood flow direction to strategies that remodel the hepatic microenvironment and target the gut-hepatic axis. This article systematically summarizes novel intervention strategies that target hepatic microenvironment remodeling, such as hepatic sinusoidal endothelial cell dysfunction, procoagulant states, and hepatocyte phenotypic transformation. Simultaneously, it focuses on reviewing the research progress on gut microbiota regulation and targeting portal vein therapy based on the \"mid-blood flow\" theory.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 7","pages":"624-629"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13416782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Distribution of serum HBV RNA in the natural history of chronic HBV infection and factors influencing HBV RNA negativity: a retrospective study stratified by HBeAg status].","authors":"Y J Li, J H Deng, Z L Yan, L P Yang, Z L Wang, Q Lu, X E Xin, J N Peng, H M Zu","doi":"10.3760/cma.j.cn501113-20260111-00020","DOIUrl":"10.3760/cma.j.cn501113-20260111-00020","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To characterize the distribution of serum hepatitis B virus (HBV) RNA in patients with HBV infection according to different HBeAg statuses and natural history stages, to analyze factors associated with HBV RNA negativity, and to observe dynamic changes in HBV RNA after six months of follow-up in patients treated with nucleos(t)ide analogues (NAs). &lt;b&gt;Methods:&lt;/b&gt; This was a single-center, retrospective, real-world cohort study. A total of 1 184 patients with chronic HBV infection who attended the Fourth People's Hospital of Qinghai Province between October 2023 and October 2025 and underwent HBV RNA testing were enrolled. Baseline characteristics and HBV RNA levels were compared after stratification by hepatitis B e antigen (HBeAg) status. Patients were classified into five stages of the natural history of chronic HBV infection according to the Guidelines for the Prevention and Treatment of Chronic Hepatitis B (2022 Edition), and HBV RNA levels were compared across stages. Two-way ANOVA was performed for HBV RNA levels using HBeAg status and baseline high-sensitivity HBV DNA status as grouping factors. Logistic regression was used to analyze factors associated with HBV RNA negativity, and a receiver operating characteristic (ROC) curve was plotted based on a multivariate model in the HBeAg-negative population. Among patients receiving NAs therapy who completed six months of follow-up, HBV RNA levels at baseline and at six months were compared, and ΔHBV RNA was compared after stratifying by baseline high-sensitivity HBV DNA status. Depending on data type, intergroup comparisons were performed using the &lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; test, Mann-Whitney &lt;i&gt;U&lt;/i&gt; test, or Kruskal-Wallis H test; pre- and post-treatment comparisons were performed using the Wilcoxon signed-rank test; and ΔHBV RNA was compared between groups using the Mann-Whitney U test. &lt;b&gt;Results:&lt;/b&gt; Among the enrolled patients, 461 were HBeAg-positive and 723 were HBeAg-negative. HBV RNA levels in the HBeAg-positive group were higher than those in the HBeAg-negative group (&lt;i&gt;P&lt;/i&gt;&lt;0.001). HBV RNA levels differed significantly across natural history stages (&lt;i&gt;P&lt;/i&gt;&lt;0.001). Two-way ANOVA showed a statistically significant main effect of HBeAg status on HBV RNA levels with a large effect size (&lt;i&gt;F&lt;/i&gt;=923.869, &lt;i&gt;P&lt;/i&gt;&lt;0.001, partial η&lt;sup&gt;2&lt;/sup&gt;=0.444). The main effect of baseline high-sensitivity HBV DNA status on HBV RNA levels was also statistically significant but with a small effect size (&lt;i&gt;F&lt;/i&gt;=3.981, &lt;i&gt;P&lt;/i&gt;=0.046, partial η&lt;sup&gt;2&lt;/sup&gt;=0.003). No significant interaction was observed between the two factors (&lt;i&gt;P&lt;/i&gt;&gt;0.05). Multivariate logistic regression showed that HBeAg negativity (&lt;i&gt;OR&lt;/i&gt;=16.028, 95% &lt;i&gt;CI&lt;/i&gt;: 9.910-25.924), lower hepatitis B surface antigen (HBsAg) level (&lt;i&gt;OR&lt;/i&gt;=0.561, 95% &lt;i&gt;CI&lt;/i&gt;: 0.475-0.663), and lower alanine aminotransferase (ALT) level (&lt;i&gt;OR&lt;/i&gt;=0.995, 95%&lt;i&gt;CI&lt;/i&gt;:0.992-0.999) were associated with HBV RNA negativity. I","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 7","pages":"675-682"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13416780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysis of the clinical characteristics of 45 cases of autoimmune liver disease in the Xizang population].","authors":"D J C Sangdan, J Wang","doi":"10.3760/cma.j.cn501113-20251206-00520","DOIUrl":"10.3760/cma.j.cn501113-20251206-00520","url":null,"abstract":"<p><p><b>Objective:</b> To explore the clinical, biochemical, immunological, and treatment characteristics of autoimmune liver disease in the Xizang population so as to provide a reference for clinical diagnosis and treatment in this region. <b>Methods:</b> Clinical data from 45 Xizang patients with autoimmune liver disease admitted to the People's Hospital of the Xizang Autonomous Region between January 2023 and August 2025 were retrospectively collected and analyzed using descriptive statistics at a single center.Intergroup comparisons were performed using the <i>χ</i>² test, Fisher's exact test, and Kruskal-Wallis <i>H</i> test. <b>Results:</b> Of the 45 patients, 38 were female (84.44%), with a male-to-female ratio of 1.00∶5.43. The average age of onset was 51.71±12.59 years, with 66.67% aged ≥45 years. Thirty-one patients (68.89%) had autoimmune hepatitis, 12 (26.67%) had primary biliary cholangitis, 2 (4.44%) had primary sclerosing cholangitis, and 2 had autoimmune hepatitis-primary biliary cholangitis overlap syndrome. Jaundice, pruritus, and fatigue were observed in 57.78% of patients, while 42.22% were already in the decompensated stage of cirrhosis at diagnosis. 28.89% had concurrent Sjögren's syndrome. The autoimmune hepatitis group had the highest levels of alanine aminotransferase (ALT) and immunoglobulin G, while the primary sclerosing cholangitis group had the highest alkaline phosphatase (ALP) levels, with statistically significant differences among the groups (<i>P</i><0.05). The positivity rate of antinuclear antibodies (ANA) was 100%, with titers≥1∶320. The positivity rate of the antimitochondrial antibody M2 subtype was 100% in the primary biliary cholangitis group. Ursodeoxycholic acid, hepatoprotective agents, glucocorticoids, and immunosuppressants were the primary treatments. The combination of glucocorticoids and immunosuppressants had yielded the highest remission rate. <b>Conclusion:</b> Autoimmune liver disease is more common among middle-aged and elderly Xizang women. Autoimmune hepatitis accounts for a higher proportion than primary biliary cholangitis, with an insidious onset, delayed diagnosis, and a high prevalence of liver cirrhosis. The spectrum of autoantibodies and biochemical markers hold diagnostic significance, while early-stage screening and standardized immunotherapy may improve prognosis.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 7","pages":"683-689"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13416773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysis of the efficacy and survival outcomes of plasma exchange combined with dual plasma molecular adsorption system therapy in liver failure].","authors":"J J Ding, L Bao, W J Cao, L Ning, H Xiao, W Y Li, H L He","doi":"10.3760/cma.j.cn501113-20251211-00525","DOIUrl":"10.3760/cma.j.cn501113-20251211-00525","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the therapeutic effect and prognostic impact of plasma exchange (PE) combined with dual plasma molecular adsorption system (DPMAS) therapy in patients with liver failure (LF). &lt;b&gt;Methods:&lt;/b&gt; A retrospective study was conducted. Data from patients with LF admitted to the Department of Infectious Diseases, Anhui Provincial Hospital, from April 2018 to July 2024 were included. Patients were divided into a PE group and a PE+DPMAS group according to the treatment modality. Propensity score matching was used to reduce baseline differences. Changes in laboratory parameters before and after treatment were analyzed to compare the efficacy of the two treatment strategies. Short-term prognostic factors associated with survival were analyzed. The differences between groups were compared using the &lt;i&gt;χ&lt;/i&gt;² test for count data. Normally distributed continuous variables were compared between groups using an independent samples t-test. Continuous variables with skewed distributions were compared between groups using the Mann-Whitney U test . Cutoff values were determined using receiver operating characteristic curve analysis. Covariates, including age, sex, etiology, type, stage, and Model for End-Stage Liver Disease score, were included in the propensity score matching. Nearest-neighbor matching was employed for 1∶1 matching of unmatched patients between the two groups (caliper value of 0.05). Survival analysis was performed using the Kaplan-Meier method. The log-rank test was used to analyze survival differences between groups. Univariate and multivariate Cox proportional survival analyses were used to explore risk factors affecting survival and to calculate hazard ratios with 95% confidence intervals. &lt;b&gt;Results:&lt;/b&gt; A total of 256 patients with LF were included. Among them, 100 patients were in the PE group and 156 patients were in the PE+DPMAS group. 76 patients were matched in each group following propensity score matching. The results showed that the PE+DPMAS group, in terms of bilirubin clearance, improvement in coagulation function, and a reduction in the Model for End-Stage Liver Disease score, had significantly superior results to the PE group (&lt;i&gt;P&lt;/i&gt;&lt;0.001). Survival analysis showed a significantly higher 8-week survival rate in the combined treatment group (81.28% vs. 56.18%, Log-rank, &lt;i&gt;P&lt;/i&gt;=0.011). Subgroup analyses according to etiology and subtype further revealed greater survival benefits among patients with hepatitis B-related LF, drug-induced LF, and chronic-onset LF treated with PE+DPMAS. Multivariate COX regression analysis confirmed that total bilirubin ≥300 μmol/L and combined DPMAS+PE therapy were independent prognostic factors. There was no statistically significant difference in the incidence of treatment-related adverse events between the two groups (&lt;i&gt;P&lt;/i&gt;&gt;0.05). &lt;b&gt;Conclusion:&lt;/b&gt; The combination of PE and DPMAS significantly improves bilirubin clearance efficiency, enhances coagulation","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 7","pages":"690-698"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13416774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}