中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
25期
1-4
,共4页
缪立英%朱滨%刘金凤%丁良才%李秀荣%金丽娜%何小舟
繆立英%硃濱%劉金鳳%丁良纔%李秀榮%金麗娜%何小舟
무립영%주빈%류금봉%정량재%리수영%금려나%하소주
吸附%血液滤过%系统性炎症反应综合征%炎性介质
吸附%血液濾過%繫統性炎癥反應綜閤徵%炎性介質
흡부%혈액려과%계통성염증반응종합정%염성개질
Adsorption%Hemofiltration%Systemic inflammatory response syndrome%Inflammatory mediator
目的 探讨全血吸附(AP)并联连续性静脉静脉血液滤过(CVVH)对系统性炎症反应综合征(SIRS)患者血清炎性介质水平的影响.方法 将63例SIRS患者按随机数字表法分为治疗组(31例,AP并联CVVH治疗)和对照组(32例,单纯CVVH治疗),比较两组患者治疗前后血清肿瘤坏死因子α (TNF-α)、C反应蛋白(CRP)、白细胞介素(IL)-1、IL-6和IL-10的变化.结果 两组治疗前血清TNF-α、CRP、IL-1、IL-6、IL-10比较差异无统计学意义(P＞ 0.05).治疗组治疗后2、26、50h的血清TNF-α、CRP、IL-1、IL-6和IL-10较治疗前明显降低[治疗后2 h:(226.4±27.6) ng/L、(70.4±22.1) mg/L、(30.1 ±2.9) ng/L、(227.5±13.2) ng/L、(40.0±5.2) ng/L,治疗后26 h:(165.3±24.5) ng/L、(58.2±25.1) mg/L、(18.2±2.7)ng/L、(82.4±7.2) ng/L、(26.2±4.3) ng/L,治疗后50 h:( 120.6±19.2) ng/L、(46.2±24.6) mg/L、( 12.4±2.3) ng/L、(38.1±4.4) ng/L、(15.2±2.1) ng/L,治疗前:(350.8±40.2)ng/L、(126.4±34.6) mg/L、(38.2±3.6) ng/L、(307.7±15.1) ng/L、(60.2±9.3)ng/L,P＜ 0.05],对照组治疗后26、50 h的血清TNF-α、CRP、IL-1、IL-6和IL-10较治疗前明显降低[治疗后26h:(262.7±29.4) ng/L、(86.4±23.7) mg/L、(29.6±3.1) ng/L、(175.0±10.6) ng/L、(42.7±5.4)ng/L,治疗后50 h:(219.3±25.6) ng/L、(75.6±24.0) mg/L、(23.5±2.8) ng/L、(99.0±8.2) ng/L、(29.3±4.8)ng/L,治疗前:(352.5±40.4) ng/L、(123.2±35.2)mg/L、(37.5±3.8) ng/L、(308.2±15.3)ng/L、(58.4±8.8) ng/L,P＜0.05],治疗组治疗后2、26、50h的血清TNF-α、CRP、IL-1、IL-6和IL-10较同期对照组明显降低(P＜0.05).结论 AP并联CVVH能有效降低SIRS患者血清炎性介质水平,疗效优于单纯CVVH.
目的 探討全血吸附(AP)併聯連續性靜脈靜脈血液濾過(CVVH)對繫統性炎癥反應綜閤徵(SIRS)患者血清炎性介質水平的影響.方法 將63例SIRS患者按隨機數字錶法分為治療組(31例,AP併聯CVVH治療)和對照組(32例,單純CVVH治療),比較兩組患者治療前後血清腫瘤壞死因子α (TNF-α)、C反應蛋白(CRP)、白細胞介素(IL)-1、IL-6和IL-10的變化.結果 兩組治療前血清TNF-α、CRP、IL-1、IL-6、IL-10比較差異無統計學意義(P＞ 0.05).治療組治療後2、26、50h的血清TNF-α、CRP、IL-1、IL-6和IL-10較治療前明顯降低[治療後2 h:(226.4±27.6) ng/L、(70.4±22.1) mg/L、(30.1 ±2.9) ng/L、(227.5±13.2) ng/L、(40.0±5.2) ng/L,治療後26 h:(165.3±24.5) ng/L、(58.2±25.1) mg/L、(18.2±2.7)ng/L、(82.4±7.2) ng/L、(26.2±4.3) ng/L,治療後50 h:( 120.6±19.2) ng/L、(46.2±24.6) mg/L、( 12.4±2.3) ng/L、(38.1±4.4) ng/L、(15.2±2.1) ng/L,治療前:(350.8±40.2)ng/L、(126.4±34.6) mg/L、(38.2±3.6) ng/L、(307.7±15.1) ng/L、(60.2±9.3)ng/L,P＜ 0.05],對照組治療後26、50 h的血清TNF-α、CRP、IL-1、IL-6和IL-10較治療前明顯降低[治療後26h:(262.7±29.4) ng/L、(86.4±23.7) mg/L、(29.6±3.1) ng/L、(175.0±10.6) ng/L、(42.7±5.4)ng/L,治療後50 h:(219.3±25.6) ng/L、(75.6±24.0) mg/L、(23.5±2.8) ng/L、(99.0±8.2) ng/L、(29.3±4.8)ng/L,治療前:(352.5±40.4) ng/L、(123.2±35.2)mg/L、(37.5±3.8) ng/L、(308.2±15.3)ng/L、(58.4±8.8) ng/L,P＜0.05],治療組治療後2、26、50h的血清TNF-α、CRP、IL-1、IL-6和IL-10較同期對照組明顯降低(P＜0.05).結論 AP併聯CVVH能有效降低SIRS患者血清炎性介質水平,療效優于單純CVVH.
목적 탐토전혈흡부(AP)병련련속성정맥정맥혈액려과(CVVH)대계통성염증반응종합정(SIRS)환자혈청염성개질수평적영향.방법 장63례SIRS환자안수궤수자표법분위치료조(31례,AP병련CVVH치료)화대조조(32례,단순CVVH치료),비교량조환자치료전후혈청종류배사인자α (TNF-α)、C반응단백(CRP)、백세포개소(IL)-1、IL-6화IL-10적변화.결과 량조치료전혈청TNF-α、CRP、IL-1、IL-6、IL-10비교차이무통계학의의(P＞ 0.05).치료조치료후2、26、50h적혈청TNF-α、CRP、IL-1、IL-6화IL-10교치료전명현강저[치료후2 h:(226.4±27.6) ng/L、(70.4±22.1) mg/L、(30.1 ±2.9) ng/L、(227.5±13.2) ng/L、(40.0±5.2) ng/L,치료후26 h:(165.3±24.5) ng/L、(58.2±25.1) mg/L、(18.2±2.7)ng/L、(82.4±7.2) ng/L、(26.2±4.3) ng/L,치료후50 h:( 120.6±19.2) ng/L、(46.2±24.6) mg/L、( 12.4±2.3) ng/L、(38.1±4.4) ng/L、(15.2±2.1) ng/L,치료전:(350.8±40.2)ng/L、(126.4±34.6) mg/L、(38.2±3.6) ng/L、(307.7±15.1) ng/L、(60.2±9.3)ng/L,P＜ 0.05],대조조치료후26、50 h적혈청TNF-α、CRP、IL-1、IL-6화IL-10교치료전명현강저[치료후26h:(262.7±29.4) ng/L、(86.4±23.7) mg/L、(29.6±3.1) ng/L、(175.0±10.6) ng/L、(42.7±5.4)ng/L,치료후50 h:(219.3±25.6) ng/L、(75.6±24.0) mg/L、(23.5±2.8) ng/L、(99.0±8.2) ng/L、(29.3±4.8)ng/L,치료전:(352.5±40.4) ng/L、(123.2±35.2)mg/L、(37.5±3.8) ng/L、(308.2±15.3)ng/L、(58.4±8.8) ng/L,P＜0.05],치료조치료후2、26、50h적혈청TNF-α、CRP、IL-1、IL-6화IL-10교동기대조조명현강저(P＜0.05).결론 AP병련CVVH능유효강저SIRS환자혈청염성개질수평,료효우우단순CVVH.
Objective To discuss the effects of adsorption (AP) combined with continuous venovenous hemofiltration (CVVH) on the serum inflammatory mediators levels in systemic inflammatory response syndrome (SIRS) patients.Methods Sixty-three SIRS patients were divided into treatment group (31 cases,AP combined with CVVH ) and control group (32 cases,CVVH ) by random digits table method.The changes of the serum tumor necrosis factor-alpha (TNF-α ),C-reactive protein (CRP),interleukin (IL)-1,IL-6 and IL-10 before and after treatment were compared in two groups.Results There was no significant difference in the serum TNF-α,CRP,IL-1,IL-6,IL-10 before treatment between two groups (P ＞ 0.05 ).The serum TNF- α,CRP,IL- 1,IL-6,IL- 10 decreased after 2,26 and 50 h treatment compared with those before treatment in treatment group[after 2 h treatment:(226.4 ± 27.6) ng/L,(70.4 ± 22.1 ) mg/L,(30.1 ±2.9) ng/L,(227.5 ± 13.2) ng/L,(40.0 ±5.2) ng/L; after 26 h treatment:(165.3 ±24.5) ng/L,(58.2 ±25.1) mg/L,(18.2 ±2.7) ng/L,(82.4 ±7.2) ng/L,(26.2 ±4.3) ng/L; after 50 h treatment:( 120.6 ± 19.2) ng/L,(46.2 ± 24.6) mg/L,( 12.4 ± 2.3 ) ng/L,(38.1 ± 4.4 ) ng/L,( 15.2 ± 2.1 ) ng/L; before treatment:(350.8 ± 40.2) ng/L,( 126.4 ± 34.6) mg/L,(38.2 ± 3.6) ng/L,(307.7 ± 15.1 ) ng/L,(60.2 ± 9.3)ng/L,P ＜0.05].The serum TNF-α,CRP,IL-1,IL-6,IL-10 decreased after 26 and 50 h treatment compared with those before treatment in control group [after 26 h treatment:(262.7 ± 29.4) ng/L,(86.4 ±23.7) mg/L,(29.6 ± 3.1) ng/L,( 175.0 ± 10.6) ng/L,(42.7 ± 5.4) ng/L; after 50 h treatment:(219.3 ±25.6 ) ng/L,(75.6 ± 24.0) mg/L,(23.5 ± 2.8 ) ng/L,(99.0 ± 8.2 ) ng/L,(29.3 ± 4.8 ) ng/L; before treatment:(352.5 ± 40.4) ng/L,( 123.2 ± 35.2) mg/L,(37.5 ± 3.8) ng/L,(308.2 ± 15.3) ng/L,(58.4 ± 8.8) ng/L,P ＜0.05].There were significant differences in the serum TNF- α,CRP,IL-1,IL-6,IL-10 after 2,26 and 50 h treatment between two groups (P ＜ 0.05).Conclusion AP combined with CVVH can effectively decrease the serum inflammatory mediators in SIRS patients and it's therapeutic effect is superior to mere CVVH.
