Abstract: Objective To observe the effect of plasma exchange （PE） on the treatment of patients with exertional heat stroke （EHS） underlying severe injuries of liver function. Methods Twelve male patients with EHS between the ages of 18 and 30 received plasma exchange therapy at early stage of the disease in addition to routine treatments from June 2013 to August 2016.The vital signs and health scoring（APACHEⅡ）of pre- and post-treatments were evaluated and ALT,AST,TBIL,CK,Cr,and D-Dimer were detected for prognosis judgement during the hospital stay. Results The life signs tended to be stable,the level of serum markers and APACHEⅡ scores decreased when compared with those before the novel therapy（P<0.05 or P<0.01）.Seven of 12 patients were recovered without any sequelae,three were improved and two died due to delayed transference to other hospital for further treatment. Conclusion The treatment strategy of plasma exchange may effectively improve the prognosis and reduce the mortality of EHS underlying severe hepatic lesions.

Key words: Exertional heat stroke, Liver lesion, Plasma exchange