Clinical significance of plasma prothrombin activity and serum alpha-fetoprotein, precursor protein in severe hepatitis patients treated with artificial liver plasma exchange

Objective To investigate the clinical significance of plasma prothrombin activity (PTA) and serum alpha fetoprotein (AFP), prealbumin (PALB) in severe hepatitis patients treated with artificial liver plasma exchange. Methods The clinical data of 31 patients with severe hepatitis were retrospectively analyzed. The patients were treated with artificial liver plasma exchange based on the comprehensive treatment. The patients were divided into survival group (17 cases) and death group (14 cases) according to the clinical outcome. The plasma prothrombin time (PT) and serum AFP, PALB levels were detected before treatment, 3rd, 9th and 18th day after treatment and at the last time (prior to discharge/in extrimis), and the PTA was counted. Results There was no statistical difference in PTA before treatment and 3rd day after treatment between 2 groups (P>0.05). The PTA levels 9th and 18th day after treatment and at the last time in death group were significantly lower than those in survival group: (30.17 ± 4.79)% vs. (39.74 ± 4.77)%, (25.47 ± 6.46)% vs. (42.79 ± 6.88)% and (21.40 ± 9.17)% vs. (47.17 ± 5.46)%,and there were statistical differences (P 0.05); the AFP levels 3rd, 9th and 18th day after treatment and at the last time in death group were significantly lower than those in survival group: (121.9 ± 31.7) μg/L vs. (134.6 ± 31.8) μg/L, (88.7 ± 40.8) μg/L vs. (169.9 ± 41.7) μg/L, (56.9 ± 29.7) μg/L vs. (176.8 ± 48.1) μg/L and (29.8 ± 15.7) μg/L vs. (204.3 ± 41.2) μg/L, and there were statistical differences (P 0.05); the PALB levels 3rd, 9th and 18th day after treatment and at the last time in death group were significantly lower than those in survival group: (107.2 ± 17.4) mg/L vs. (126.3 ± 33.2) mg/L, (91.2 ± 11.9) mg/L vs. (137.9 ± 35.7) mg/L, (54.7 ± 14.8) mg/L vs. (151.9 ± 27.9) mg/L and (43.3 ± 19.7) mg/L vs. (159.3 ± 41.2) mg/L, and there were statistical differences (P<0.05). Conclusions The plasma PTA and serum AFP, PALB levels are closely related with curative effect of artificial liver plasma exchange in severe hepatitis patients, and dynamic observation of its changes can help to determine the condition. Key words: Hepatitis; Prothrombin; Alpha-fetoproteins; Prealbumin; Liver, artificial; Plasma exchange