CAJ | 학술논문

目的：回顾性分析短时静-静脉血液滤过(SVVH)治疗急性胰腺炎(AP)合并Ⅱ期急性肾损伤(AKI)的临床意义。方法：回顾性分析AP合并Ⅱ期AKI患者51例，将在Ⅱ期AKI时开始行SVVH治疗的患者设为SVVH组24例，在Ⅱ期AKI时只接受常规治疗的患者设为对照组27例，血液净化方式为SVVH每日12 h，比较两组患者治疗1周后BUN、Cr、胱抑素C、降钙素原（PCT）、C反应蛋白（CRP）、白细胞水平变化、心率、呼吸、平均动脉压、尿量等基本生命体征的变化，及APACHEⅡ评分和AKI分期的变化。结果：两组患者在治疗1周后，SVVH组患者AKI分期总体低于对照组，进展为Ⅲ期AKI的患者比例为20.8%，小于对照组的40.7%（P＜0.01）。SVVH组患者血BUN平均值为(11.43±3.25) mmol/L,低于对照组的(17.31±9.52) mmol/L；SCr平均值为(179.63±152.01)μmol/L,低于对照组的(415.31±253.43)μmol/L；胱抑素C平均值为(1.98±0.97) mg/L,低于对照组的(3.19±1.24) mg/L；尿量平均值为(0.66±0.39) mL·kg-1·h-1，大于对照组的(0.43±0.21) mL·kg-1·h-1。SVVH组患者APACHEⅡ评分平均值为(13.77±7.19)，小于对照组的(15.68±6.41)（P＜0.05）。SVVH组患者PCT平均值为（2.48±1.52）ng/mL，低于对照组的（7.01±4.51）ng/mL；CRP平均值为（99.67±68.07）mg/L，低于对照组的（120.39±98.43）mg/L；血白细胞平均值为（9.56±4.22）×109/L，低于对照组的（12.56±8.34）×109/L。结论：在AP患者合并Ⅱ期AKI时行SVVH治疗，对保护肾功能具有积极作用。
목적：회고성분석단시정-정맥혈액려과(SVVH)치료급성이선염(AP)합병Ⅱ기급성신손상(AKI)적림상의의。방법：회고성분석AP합병Ⅱ기AKI환자51례，장재Ⅱ기AKI시개시행SVVH치료적환자설위SVVH조24례，재Ⅱ기AKI시지접수상규치료적환자설위대조조27례，혈액정화방식위SVVH매일12 h，비교량조환자치료1주후BUN、Cr、광억소C、강개소원（PCT）、C반응단백（CRP）、백세포수평변화、심솔、호흡、평균동맥압、뇨량등기본생명체정적변화，급APACHEⅡ평분화AKI분기적변화。결과：량조환자재치료1주후，SVVH조환자AKI분기총체저우대조조，진전위Ⅲ기AKI적환자비례위20.8%，소우대조조적40.7%（P＜0.01）。SVVH조환자혈BUN평균치위(11.43±3.25) mmol/L,저우대조조적(17.31±9.52) mmol/L；SCr평균치위(179.63±152.01)μmol/L,저우대조조적(415.31±253.43)μmol/L；광억소C평균치위(1.98±0.97) mg/L,저우대조조적(3.19±1.24) mg/L；뇨량평균치위(0.66±0.39) mL·kg-1·h-1，대우대조조적(0.43±0.21) mL·kg-1·h-1。SVVH조환자APACHEⅡ평분평균치위(13.77±7.19)，소우대조조적(15.68±6.41)（P＜0.05）。SVVH조환자PCT평균치위（2.48±1.52）ng/mL，저우대조조적（7.01±4.51）ng/mL；CRP평균치위（99.67±68.07）mg/L，저우대조조적（120.39±98.43）mg/L；혈백세포평균치위（9.56±4.22）×109/L，저우대조조적（12.56±8.34）×109/L。결론：재AP환자합병Ⅱ기AKI시행SVVH치료，대보호신공능구유적겁작용。
Objective To study the clinical significance of short venovenous hemofiltration therapy on acute pancreatitis with Ⅱstage acute kidney injury. Methods Fifty one patients with acute pancreatitis com?bined Ⅱ stage acute kidney injury were analysed retrospectively,24 patients were selected as short venovenous hemofiltration treatment (SVVH) group who were treated with conventional methods and short venovenous hemo?filtration,12 hours per day. the other 27 patients only took conservative treatment were chosen as control group. The blood ureanitrogen (BUN),Serum creatinine (Cr),procallcitonin(PCT),Cystatin C(Cys C),C-reactive protein (CRP),Leucocyte level,heart rate (HR),respiratory rate (RR),mean arterial pressure (MAP),urine volume, APACHEⅡ scores and AKI stage of the two groups were taken for comparison and observation after a week of the treatment. Results After one week of treatment,the Ⅲ stage AKI patients proportion of the SVVH group was 20.8%,lower than that of control group 40.7% (P<0.05). In the SVVH group the average value of BUN was (11.43+3.25) mmol/L, lower than that of control group (17.31±9.52) mmol/L(P<0.05); the average value of SCr was (179.63±152.01)μmol/L, lower than that of control group (415.31±253.43)μmol/L(P<0.05);the aver?age value of Cystatin C was (1.98±0.97) mg/L, lower than that of control group (3.19±1.24) mg/L(P<0.05); the average amount of urine was (0.66±0.39) mL·kg-1·h-1, higher than that of control group (0.43+0.21) mL·kg-1·h-1 (P<0.05); the average value of APACHE II scores was 13.77 ± 7.19, less than that of control group 15.68+6.41 (P<0.05); the average value of PCT was (2.48±1.52) ng/mL, lower than that of control group (7.01±4.51) ng/mL (P<0.05); the average value of CRP was (99.67±68.07) mg/L, lower than that of control group (120.39±98.43) mg/L(P<0.05); the average value of CRP was (99.67 ± 68.07) mg/L, lower than that of control group (120.39 ± 98.43) mg/L(P<0.05); the average number of white cells was (9.56 ± 4.22) × 109/L, lower than that of control group (12.56±8.34)×109/L. Conclusion In AP with Ⅱstage AKI, SVVH treatment can protect the renal func?tion of the patient.