中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2015年
7期
973-975
,共3页
谢敏丹%陈海丽%林肖琴%张近波
謝敏丹%陳海麗%林肖琴%張近波
사민단%진해려%림초금%장근파
胰腺炎%白细胞介素%肿瘤坏死因子-α%连续性肾替代治疗%氧合指数%急性肺损伤/急性呼吸窘迫综合征
胰腺炎%白細胞介素%腫瘤壞死因子-α%連續性腎替代治療%氧閤指數%急性肺損傷/急性呼吸窘迫綜閤徵
이선염%백세포개소%종류배사인자-α%련속성신체대치료%양합지수%급성폐손상/급성호흡군박종합정
Pancreatitis%Interleukin%Tumor necrosis factor-α%Continuous renal replacement therapy%Oxy-genation index%Acute lung injury/acute respiratory distress syndrome
目的：探讨早期连续性肾替代治疗（CRRT）对重症急性胰腺炎（SAP）患者急性肺损伤及预后的影响。方法将46例重症急性胰腺炎患者按照平行对照设计原理分为对照组和CRRT组。对两组IL-1β、IL-6、TNF-α水平、APACHEⅡ评分、氧合指数变化、急性肺损伤／急性呼吸窘迫综合征（ALI／ARDS）发生率及入住 ICU 时间进行比较。结果与CRRT组比较，对照组第1天IL-6水平均明显升高（t＝2．265，P＜0.05）；与CRRT组比较，对照组第3天IL-1β、IL-6、TNF-α水平均明显升高（t＝2．305、2．471、2．293，均P＜0.05）；与CRRT组比较，对照组第3天氧合指数均明显降低（t＝2．386，P＜0．05）。与对照组比较，CRRT组ALI／ARDS发生率、ICU住院时间、病死率明显降低（均P＜0．05）。两组性别、年龄、APACHE Ⅱ评分等差异均无统计学意义（均P＞0．05）。结论早期CRRT治疗SAP患者能通过清除重症胰腺炎患者IL-1β、IL-6、TNF-α等细胞因子，降低SAP患者ALI／ARDS发生率及升高氧合指数，使重症胰腺炎患者获得更大的临床效益。
目的：探討早期連續性腎替代治療（CRRT）對重癥急性胰腺炎（SAP）患者急性肺損傷及預後的影響。方法將46例重癥急性胰腺炎患者按照平行對照設計原理分為對照組和CRRT組。對兩組IL-1β、IL-6、TNF-α水平、APACHEⅡ評分、氧閤指數變化、急性肺損傷／急性呼吸窘迫綜閤徵（ALI／ARDS）髮生率及入住 ICU 時間進行比較。結果與CRRT組比較，對照組第1天IL-6水平均明顯升高（t＝2．265，P＜0.05）；與CRRT組比較，對照組第3天IL-1β、IL-6、TNF-α水平均明顯升高（t＝2．305、2．471、2．293，均P＜0.05）；與CRRT組比較，對照組第3天氧閤指數均明顯降低（t＝2．386，P＜0．05）。與對照組比較，CRRT組ALI／ARDS髮生率、ICU住院時間、病死率明顯降低（均P＜0．05）。兩組性彆、年齡、APACHE Ⅱ評分等差異均無統計學意義（均P＞0．05）。結論早期CRRT治療SAP患者能通過清除重癥胰腺炎患者IL-1β、IL-6、TNF-α等細胞因子，降低SAP患者ALI／ARDS髮生率及升高氧閤指數，使重癥胰腺炎患者穫得更大的臨床效益。
목적：탐토조기련속성신체대치료（CRRT）대중증급성이선염（SAP）환자급성폐손상급예후적영향。방법장46례중증급성이선염환자안조평행대조설계원리분위대조조화CRRT조。대량조IL-1β、IL-6、TNF-α수평、APACHEⅡ평분、양합지수변화、급성폐손상／급성호흡군박종합정（ALI／ARDS）발생솔급입주 ICU 시간진행비교。결과여CRRT조비교，대조조제1천IL-6수평균명현승고（t＝2．265，P＜0.05）；여CRRT조비교，대조조제3천IL-1β、IL-6、TNF-α수평균명현승고（t＝2．305、2．471、2．293，균P＜0.05）；여CRRT조비교，대조조제3천양합지수균명현강저（t＝2．386，P＜0．05）。여대조조비교，CRRT조ALI／ARDS발생솔、ICU주원시간、병사솔명현강저（균P＜0．05）。량조성별、년령、APACHE Ⅱ평분등차이균무통계학의의（균P＞0．05）。결론조기CRRT치료SAP환자능통과청제중증이선염환자IL-1β、IL-6、TNF-α등세포인자，강저SAP환자ALI／ARDS발생솔급승고양합지수，사중증이선염환자획득경대적림상효익。
Objective To investigate the effects of early continuous renal replacement thempy(CRRT)on acute lung injury and prognosis in severe acute pancreatitis (SAP)patients.Methods 46 SAP patients were divided into the two groups randomly:the control group and CRRT treatment group.The levels of IL-1β,IL-6,TNF-α,the APACHEⅡscore,oxygenation index,the incidence of acute lung injury(ALI)/acute respiratory distress syndrome (ARDS),ICU stay were compared between the two groups.Results The level of interleukin-6(IL-6)in the con-trol group was significantly higher than that in CRRT group in day 1(t=2.265,P<0.05);The levels of interleukin-1β(IL-1β),interleukin-6 (IL-6 ),tumor necrosis factor-α(TNF -α)in the control group were significantly higher than that in CRRT group in day 3(t=2.305,2.471,2.293,all P<0.05);the oxygenation index in the control group was significantly lower than that in CRRT group in day 3(t=2.386,P<0.05);the incidence of ALI/ARDS, the ICU stay days,the fatality rate in the control group were significantly higher than that in CRRT group(P<0.05);there was no significant differences between late group than that early group in gender,age,APACHE Ⅱ score (all P>0.05).Conclusion Early CRRT therapy can eliminate the IL-1β,IL-6 and TNF-αin SAP patients,which can improve the oxygenation index and reduce the incidences of ALI/ARDS,may provide more clinical benefits in the early phase of SAP.
