目的 探讨低置换量血浆置换术（LPE）+双重血浆分子吸附术（DPMAS）联合治疗慢加急性肝衰竭（ACLF）患者的效果，及对患者肝功能、炎症细胞因子及短期预后的影响。 方法 使用信封法将100例ACLF患者随机分为观察组和对照组，各50例。两组均常规予以护肝、退黄、降酶、抗病毒、预防出血等治疗。对照组在常规治疗基础上，予以血浆置换（PE）治疗；观察组在常规治疗基础上，予以LPE+DPMAS联合治疗。比较两组患者治疗后肝功能、凝血功能、炎症细胞因子水平、不良反应发生率及90 d生存率。 结果 治疗后，观察组患者肝功能、凝血功能及炎症细胞因子水平均优于对照组（P < 0.05）。两组患者90 d生存率和不良反应总发生率比较，差异无统计学意义（P > 0.05）。 结论 LPE+DPMAS联合治疗ACLF患者，可有效改善肝功能及凝血功能，降低炎症因子水平，安全性高。

Objective To explore the effect of low replacement plasma exchange （LPE） combined with double plasma molecular adsorption （DPMAS） in the treatment of patients with chronic acute liver failure （ACLF） and its influence on liver function， inflammatory cytokines and short-term prognosis. Methods One hundred patients with ACLF were randomly divided into the observation group and the control group by envelope method， with 50 cases in each group. On basis of routine symptomatic treatments （liver protection， removing jaundice， reducing enzymes， anti-viruses， bleeding prevention）， the control group and the observation group were treated with plasma exchange （PE） and LPE plus DPMAS， respectively. The liver function， coagulation function， the levels of inflammatory cytokines， incidence of adverse reactions， and 90-day survival rate were compared between the two groups after treatment. Results After treatment， the liver function and coagulation function in the observation group were significantly improved （P < 0.05） and the levels of inflammatory cytokines were significantly lowered than those in the control group （P < 0.05）. There was no statistically significant difference in the 90-day survival rate and the total incidence of adverse reactions between the groups （P > 0.05）. Conclusion LPE combined with DPMAS can effectively improve liver function and coagulation function， and reduce levels of inflammatory cytokines in ACLF patients， with high safety.