CAJ | 학술논문

目的探讨腹膜透析(PD)对重症急性胰腺炎(SAP)细胞因子的影响.方法 2000年1月至2006年7月青州医院.肾内科收治的48例SAP患者随机分为腹膜透析组(PD组)和非腹膜透析组(NPD组).PD组运用腹膜透析技术对24例SAP患者进行腹膜透析治疗,NPD组运用常规治疗.比较两组的腹痛、腹胀缓解时间、CT积分、APACHE Ⅱ积分以及住院时间、住院费用、转手术率、并发症发生率和治愈率.比较两组血浆、腹膜透析液中TNF-α,IL-6,IL-8,IL-10和CRP细胞因子在治疗前后各时相点的含量.结果 PD组及NPD组腹痛消失和腹胀缓解时间为(19.70±7.32)h vs.(81.46±36.68)h和(23.16±6.95)h vs.(78.19±29.26)h;两组比较PD组明显优于NPD组(P<0.05).治疗后PD组血浆中促炎细胞因子TNF-α,IL-6,IL-8和CRP在各时相点较NPD组显著降低(P<O.05),抗炎细胞因子较NPD组显著升高(P<0.05).结论 PD有利于纠正SAP早期促炎细胞因子过度释放和抗炎细胞因子失衡.且PD对早期SAP疗效显著,方法简单、费用低、创伤小、并发症少,值得进一步推广应用和研究.
목적 탐토복막투석(PD)대중증급성이선염(SAP)세포인자적영향.방법 2000년1월지2006년7월청주의원.신내과수치적48례SAP환자수궤분위복막투석조(PD조)화비복막투석조(NPD조).PD조운용복막투석기술대24례SAP환자진행복막투석치료,NPD조운용상규치료.비교량조적복통、복창완해시간、CT적분、APACHE Ⅱ적분이급주원시간、주원비용、전수술솔、병발증발생솔화치유솔.비교량조혈장、복막투석액중TNF-α,IL-6,IL-8,IL-10화CRP세포인자재치료전후각시상점적함량.결과 PD조급NPD조복통소실화복창완해시간위(19.70±7.32)h vs.(81.46±36.68)h화(23.16±6.95)h vs.(78.19±29.26)h;량조비교PD조명현우우NPD조(P<0.05).치료후PD조혈장중촉염세포인자TNF-α,IL-6,IL-8화CRP재각시상점교NPD조현저강저(P<O.05),항염세포인자교NPD조현저승고(P<0.05).결론 PD유리우규정SAP조기촉염세포인자과도석방화항염세포인자실형.차PD대조기SAP료효현저,방법간단、비용저、창상소、병발증소,치득진일보추엄응용화연구.
Objective To ivevstigate the feasibility, the effects and the therapy of peritoneal dialysis(PD) on severe acute pancreatitis (SAP). Method From January,2001 to Jaly 2006,48 patients of SAP were divided randomly into PD group and non-PD group in Qingzhou hospital. Both groups were treated by the conventional mode of therapy. In PD group , using the concept of PD,24 patients of SAP were treated with PD and NPD group were treated only with common therapy. The release time of abdominal pain and distention, CT scores, APACHE II scores, the time of hospital stay, cost of treatment in hospital, operative rate and rate of complications and recovered rate of the two groups were compared. Simutaneously. the concentration of serum and fluid filtrated inflammatory cytokines TNFα,IL-6,IL-8,IL-10 and CRP were also determined pro and post the therapy. Results In the PD and NPD group, the duration for disappear-ance of abdominal pain and tenderness,and amelioration for abdominal distension was (19.70 ±7.32) hvs. (81.46±36.68) h and (23.16±6.95) h vs.(78.19± 29.26) h;So that the PD group was precede to that in NPD group ( P < 0.05). The concentration of serum and fluid filtrated pro-inflammatory cytokines TNFα, IL-6, IL-8 and CRP at each observation points after PD was decreased significantly (P <0.05) in the PD group. But the concentration of the serum and fluid filtrated anti-inflammatory cytokines IL-10 was increased significantly (P < 0.05) as compared with that of the NPD group. Conclusions Through PD, the imbalance of pro-inflammatory and anti-inflammatory cytokines has been corrected at early stage of SAP. But the PD is method that is easy, quick, small wou-ndell,few complicated and effective in patients with early-phase SAP, and will be of great value in wide application and further study.