[Influence of plasma exchange on serum cytokines in severe viral hepatitis patients].

Objective: To evaluate the changes of serum cytokines vary with plasma exchange (PE) therapy in patients with severe viral hepatitis.

Methods: Forty patients suffering from severe liver failure were randomized and treated by PE therapy. The tumor necrosis factor-alpha (TNF-alpha), interleukin-4 (IL-4) levels and liver function before and after PE therapy were examined. Moreover, the relation of TNF-alpha, IL-4 levels and the efficacy of PE, liver function and the compliment were also observed.

Results: It showed that the TNF-alpha and IL-4 level of the serum were decreased after PE therapy. The TNF-alpha level of the serum was(79.32+/-22.39) ng/L before treatment and (20.01+/-22.25) ng/L after treatment (P<0.001), IL-4 was(0.61+/-0.07) ng/L before treatment and (0.57+/-0.06) ng/L after treatment (P<0.01). There were more differences between recovering patients and worsen ones (P<0.05 or P<0.01). There was remarkable difference between recovering patients and worsen ones in the liver function improvement (P<0.05 or P<0.01), the severe symptom ( P<0.01 and P<0.05) and the complication (P<0.01).

Conclusion: PE therapy can effectively purge or reduce TNF-alpha, IL-4 and is a method treating and preventing the complication. The worsen patients have continuous inflammation and higher level of TNF-alpha and IL-4.