CAJ | 학술논문

目的：探讨高容量血液滤过（ HVHF）对老年严重脓毒症患者肠屏障功能的影响。方法按随机原则将严重脓毒症患者分为常规治疗组31例，联合HVHF组23例，分别于入住ICU当时、第2天、第3天、第7天采集外周血，测定血浆肠型脂肪酸结合蛋白（ IFABP）、二胺氧化酶（ DAO）、D-乳酸，并记录28 d病死率。结果治疗前两组IFABP、DAO、D-乳酸水平比较差异无统计学意义（P＞0．05），治疗后均有所下降，除第3天两组血浆IFABP水平比较差异无统计学意义（ P＞0．05）外，其余各时间点联合HVHF组较同期常规治疗组各指标均显著下降（ P＜0.05）。联合HVHF组28 d病死率显著低于常规治疗组（39．1％ vs 80.6％， P＜0．05）。结论HVHF对老年严重脓毒症患者肠屏障功能具有保护作用，可显著降低病死率，并改善预后。
목적：탐토고용량혈액려과（ HVHF）대노년엄중농독증환자장병장공능적영향。방법안수궤원칙장엄중농독증환자분위상규치료조31례，연합HVHF조23례，분별우입주ICU당시、제2천、제3천、제7천채집외주혈，측정혈장장형지방산결합단백（ IFABP）、이알양화매（ DAO）、D-유산，병기록28 d병사솔。결과치료전량조IFABP、DAO、D-유산수평비교차이무통계학의의（P＞0．05），치료후균유소하강，제제3천량조혈장IFABP수평비교차이무통계학의의（ P＞0．05）외，기여각시간점연합HVHF조교동기상규치료조각지표균현저하강（ P＜0.05）。연합HVHF조28 d병사솔현저저우상규치료조（39．1％ vs 80.6％， P＜0．05）。결론HVHF대노년엄중농독증환자장병장공능구유보호작용，가현저강저병사솔，병개선예후。
Objective Tto evaluate the change in intestinal barrier function in patients with severe sepsis during HVHF therapy .Methods Fifty -four patients were randomly divided into the control group ( n =31 ) and the HVHF group ( n =23 ) .Peripheral blood from sepsis patients were routinely collected on day 0, 2, 3, 7 after admission.The levels of IFABP, DAO and D-lactate were measured, and death rate of patients in 28 days were recorded.Results There was no difference between the two groups at baseline .However , compared with the conventional treatment group , the plasma levels of IFABP , DAO and D-lactate of HVHF group after HVHF were significantly decreased except for IFABP on day 3 (P<0.05), and the 28-day mortality was significantly reduced (39.1%vs 80.6%, P <0.05).Conclusion HVHF can protect intestinal barrier function, and reduce the mortality as well as improve clinical outcome in elderly patients with sepsis .