中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2008年
8期
855-858
,共4页
ZHANG Biao%姜波健%ZHU Yi-ming%王大铮
ZHANG Biao%薑波健%ZHU Yi-ming%王大錚
ZHANG Biao%강파건%ZHU Yi-ming%왕대쟁
胰腺%炎症%血液过滤%白细胞介素-6
胰腺%炎癥%血液過濾%白細胞介素-6
이선%염증%혈액과려%백세포개소-6
Pancreas%Inflananation%Hemedialysis%lntedeukin-6(IL-6)
目的 探讨早期短时血滤清除血清白介素-6(IL-6)在重症急性胰腺炎治疗中的作用及机制.方法 根据诊断标准对重症急性胰腺炎患者进行前瞻性对照研究,将上海交通大学医学院附属第三人民医院普外科收治的178例重症急性胰腺炎患者随机分组:血滤组(HF组)85人,非血滤组(NHFF组)93人.比较两组患者的症状、APACHE II评分、住院时间和费用、MODS发病率和病死率,并比较各时相点促炎细胞因子血清IL-6的测定值.数据以SPSS统计软件处理,采用SNK-q检验和X2检验进行数据分析.结果 HF组与NHF组比较:腹痛腹胀持续时间为(18.8±4.2)h vs.(89.7±28.1)h(P<0.05);治疗后第10天APACHE Ⅱ积分为(5.5±3.6)分vs.(13.8±3.8)分(P<0.05);住院天数和医疗费为(28.2±12.4)d vs.(42.4±11.2)d和(4.38±2.8)万元vs.(7.46±2.2)万元,(P<0.05).治疗后各时相点血清IL-6检测结果:HF组较NItF组显著降低(P<0.05);MODS发病率和病死率分别为12.47%vs.36.28%和4.28%vs.12.82%,两者差异有统计学意义(P<0.05).结论 早期短时血滤有利于纠正重症急性胰腺炎患者血清促炎细胞因子过度释放,使病情减轻,降低MODS发病率和病死率,提高疗效.
目的 探討早期短時血濾清除血清白介素-6(IL-6)在重癥急性胰腺炎治療中的作用及機製.方法 根據診斷標準對重癥急性胰腺炎患者進行前瞻性對照研究,將上海交通大學醫學院附屬第三人民醫院普外科收治的178例重癥急性胰腺炎患者隨機分組:血濾組(HF組)85人,非血濾組(NHFF組)93人.比較兩組患者的癥狀、APACHE II評分、住院時間和費用、MODS髮病率和病死率,併比較各時相點促炎細胞因子血清IL-6的測定值.數據以SPSS統計軟件處理,採用SNK-q檢驗和X2檢驗進行數據分析.結果 HF組與NHF組比較:腹痛腹脹持續時間為(18.8±4.2)h vs.(89.7±28.1)h(P<0.05);治療後第10天APACHE Ⅱ積分為(5.5±3.6)分vs.(13.8±3.8)分(P<0.05);住院天數和醫療費為(28.2±12.4)d vs.(42.4±11.2)d和(4.38±2.8)萬元vs.(7.46±2.2)萬元,(P<0.05).治療後各時相點血清IL-6檢測結果:HF組較NItF組顯著降低(P<0.05);MODS髮病率和病死率分彆為12.47%vs.36.28%和4.28%vs.12.82%,兩者差異有統計學意義(P<0.05).結論 早期短時血濾有利于糾正重癥急性胰腺炎患者血清促炎細胞因子過度釋放,使病情減輕,降低MODS髮病率和病死率,提高療效.
목적 탐토조기단시혈려청제혈청백개소-6(IL-6)재중증급성이선염치료중적작용급궤제.방법 근거진단표준대중증급성이선염환자진행전첨성대조연구,장상해교통대학의학원부속제삼인민의원보외과수치적178례중증급성이선염환자수궤분조:혈려조(HF조)85인,비혈려조(NHFF조)93인.비교량조환자적증상、APACHE II평분、주원시간화비용、MODS발병솔화병사솔,병비교각시상점촉염세포인자혈청IL-6적측정치.수거이SPSS통계연건처리,채용SNK-q검험화X2검험진행수거분석.결과 HF조여NHF조비교:복통복창지속시간위(18.8±4.2)h vs.(89.7±28.1)h(P<0.05);치료후제10천APACHE Ⅱ적분위(5.5±3.6)분vs.(13.8±3.8)분(P<0.05);주원천수화의료비위(28.2±12.4)d vs.(42.4±11.2)d화(4.38±2.8)만원vs.(7.46±2.2)만원,(P<0.05).치료후각시상점혈청IL-6검측결과:HF조교NItF조현저강저(P<0.05);MODS발병솔화병사솔분별위12.47%vs.36.28%화4.28%vs.12.82%,량자차이유통계학의의(P<0.05).결론 조기단시혈려유리우규정중증급성이선염환자혈청촉염세포인자과도석방,사병정감경,강저MODS발병솔화병사솔,제고료효.
Objective To study the therapeutic effect and mechanism of IL-6 reduced by the early shortlime veno-venous hemodialysis (BVVH) for the treatmnent of severe acute pancreatitis (SAP).Method One hundred and seventy-eight cases with SAP,in depagtment of general surgery,the Third People Hospital,Shanghai Jiao Tong University School of Medicine,were divided inlo hemodialysis group (HF,85 cases) and non-hemodialysis group (NHF,93 cases).The local and systemic manifestations,APACHE Ⅱ scores,average hospitalizing stay,mean cost of therapy,morbidity of MODS and the mortality of patients were compared between two groups.And the concentration of serum inflammatory factor IL-6 was assayed at different observation intervals.All data were managed by SPSS software and analyzed by using SNK-q test or X2 test.Results The duration for abdominal pain and distension in patiergs of HF group was (18.8+=4.2) h vs.(89.7±28.1) h in those of NHF group,P<0.05.The APACHE Ⅱ scores at the 10th day were (5.5±3.6) vs.(13.8±3.8) (P<0.05).The average hospitalizing stay and the mean costs of medical care were (28.2+ 12.4) d vs.(42.4+11.2) d and (43800±28000) vs.(74600±22000) RMB(P<0.05) respectively.The concontrafion of serum inflammatory factor IL-6 in HF group decreased significantly(P<0.05) in comparison with those in NHF group.And the morbidity such as MODS and the mortality in HF group were significantly less than those in NHF group(P<0.05).Conclusions By BWH,the excessive release of serum inflammatory factor IL-6 could he removed at early stage of SAP.So,it could result in an improving on the severity of the disease and raise the therapeutic efficacy.
