中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2009年
1期
12-14
,共3页
肖雄箭%林建东%李玮%阙敢波
肖雄箭%林建東%李瑋%闕敢波
초웅전%림건동%리위%궐감파
多器官功能障碍综合征%降钙素原%高容量血液滤过
多器官功能障礙綜閤徵%降鈣素原%高容量血液濾過
다기관공능장애종합정%강개소원%고용량혈액려과
Multiple organ dysfunction syndrome%Procalcitonin%High volume haemofihration
目的 探讨高容量血液滤过(HVHF)对多器官功能障碍综合征(MODS)患者血浆降钙素原(PCT)的影响.方法 选择MODS患者40例,随机分为对照组和HVHF组,对照组采用传统的西医治疗方法,HVHF组在传统治疗基础上行HVHF治疗,分别测定2组患者血白细胞总数(WBC)、中性粒细胞(N)百分比、血乳酸(Lac-)、血浆PCT以及APACHE Ⅱ评分.比较2组患者的病死率以及存活组和死亡组PCT、APACHE Ⅱ的差别.结果 2组患者治疗前各项指标无差别,对照组经传统西医治疗后5～7 d部分指标才开始下降(P＜0.05或P＜0.01),而HVHF组治疗后第1天各项指标即开始下降(P均＜0.05),HVHF治疗后5～7 d各项指标均显著低于对照组(P均＜0.01).HVHF组病死率明显低于对照组(P＜0.05),分别为10%和40%;存活组PCT水平、APACHE Ⅱ评分明显低于死亡组(P均＜0.01),分别为(3.8±2.6)μg/L、(7.6±3.8)分和(12.9±7.8)μg/L、(14.5 ±8.4)分.结论 HVHF能降低MODS患者的血浆PCT,降低MODS病死率,改善MODS患者预后.
目的 探討高容量血液濾過(HVHF)對多器官功能障礙綜閤徵(MODS)患者血漿降鈣素原(PCT)的影響.方法 選擇MODS患者40例,隨機分為對照組和HVHF組,對照組採用傳統的西醫治療方法,HVHF組在傳統治療基礎上行HVHF治療,分彆測定2組患者血白細胞總數(WBC)、中性粒細胞(N)百分比、血乳痠(Lac-)、血漿PCT以及APACHE Ⅱ評分.比較2組患者的病死率以及存活組和死亡組PCT、APACHE Ⅱ的差彆.結果 2組患者治療前各項指標無差彆,對照組經傳統西醫治療後5～7 d部分指標纔開始下降(P＜0.05或P＜0.01),而HVHF組治療後第1天各項指標即開始下降(P均＜0.05),HVHF治療後5～7 d各項指標均顯著低于對照組(P均＜0.01).HVHF組病死率明顯低于對照組(P＜0.05),分彆為10%和40%;存活組PCT水平、APACHE Ⅱ評分明顯低于死亡組(P均＜0.01),分彆為(3.8±2.6)μg/L、(7.6±3.8)分和(12.9±7.8)μg/L、(14.5 ±8.4)分.結論 HVHF能降低MODS患者的血漿PCT,降低MODS病死率,改善MODS患者預後.
목적 탐토고용량혈액려과(HVHF)대다기관공능장애종합정(MODS)환자혈장강개소원(PCT)적영향.방법 선택MODS환자40례,수궤분위대조조화HVHF조,대조조채용전통적서의치료방법,HVHF조재전통치료기출상행HVHF치료,분별측정2조환자혈백세포총수(WBC)、중성립세포(N)백분비、혈유산(Lac-)、혈장PCT이급APACHE Ⅱ평분.비교2조환자적병사솔이급존활조화사망조PCT、APACHE Ⅱ적차별.결과 2조환자치료전각항지표무차별,대조조경전통서의치료후5～7 d부분지표재개시하강(P＜0.05혹P＜0.01),이HVHF조치료후제1천각항지표즉개시하강(P균＜0.05),HVHF치료후5～7 d각항지표균현저저우대조조(P균＜0.01).HVHF조병사솔명현저우대조조(P＜0.05),분별위10%화40%;존활조PCT수평、APACHE Ⅱ평분명현저우사망조(P균＜0.01),분별위(3.8±2.6)μg/L、(7.6±3.8)분화(12.9±7.8)μg/L、(14.5 ±8.4)분.결론 HVHF능강저MODS환자적혈장PCT,강저MODS병사솔,개선MODS환자예후.
Objective To investigate the effect of hiigh volume haemofihration(HVHF)on plasma procalcitonin(PCT)in patients with multiple organ dysfunction syndrome(MODS).Methods 40 patients with MODS were randomly divided into control group and HVHF group.The control group received traditional west medicine therapy and the HVHF group received HVHF as well as the traditional west medicine therapy.White blood cell (WBC),neutrophil(N),PCT,lactic acid(Lac-)and APACHE Ⅱ score,were measured in both groups,the mortality in both groups wag compared.PCT and APACHE Ⅱ were also compared between the survival group and dead group.Results The above indexes had no difference between the groups before the treatment.Partial indexes in the control group decreased at 5-7 d while those decreased earlier at 1 d through 7 d in HVHF group(P＜0.05).All observed indexes at 5-7 d in the HVHF group were significantly lower than those in the control group(P＜0.01).Compared with the control group,the mortality in HVHF group wag markedly lower(10%vs 40%,P＜0.05).The level of PCT and APACHE Ⅱ score in the survival group were significantly lower than those in the dead group [(3.8 4-2.6)μg/L vs(12.9 ±7.8)μg/L and 7.6±3.8 vs 14.5±8.4 respectively,P＜0.01].Conclusion HVHF could effectively decrease plasma PCT,reduce the mortality of patients with MODS and improve outcome.
