临床和实验医学杂志
臨床和實驗醫學雜誌
림상화실험의학잡지
JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE
2015年
7期
580-582
,共3页
周海琪%陈明祺%裴颖皓%张海东%吕海%王醒
週海琪%陳明祺%裴穎皓%張海東%呂海%王醒
주해기%진명기%배영호%장해동%려해%왕성
脓毒血症%急性肾损伤%NMRC - DHP%CVVH IL - 6%TNF - α
膿毒血癥%急性腎損傷%NMRC - DHP%CVVH IL - 6%TNF - α
농독혈증%급성신손상%NMRC - DHP%CVVH IL - 6%TNF - α
Sepsis%Acute renal impairment%NMRC - DHP%CVVH%IL - 6%TNF - α
目的:探讨中性大孔径树脂血液灌流(NMRC - DHP)联合连续性静脉-静脉滤过(CVVH)对脓毒血症合并急性肾损伤患者白介素6(IL -6)、肿瘤坏死因子α(TNF -α)水平及器官功能的影响。方法选择脓毒血症合并急性肾损伤患者共46例,随机分为研究组和对照组(各23例),研究组行 NMRC - DHP + CVVH 治疗,对照组只进行 CV-VH。通过序贯器官衰竭评分(SOFA)、氧合指数(OI)、平均动脉压(MAP)以及血清白介素6(IL -6)和肿瘤坏死因子α(TNF -α)的水平变化,评价两者在对脓毒血症合并急性肾损伤患者的疗效。结果治疗后24 h 和治疗后72 h,两组血清 IL -6和 IL -10水平较治疗前均出现了显著下降( P <0.05),研究组治疗后显著低于对照组( P <0.05)。治疗后两组 OI 和 MAP 出现显著上升,Scr 出现明显下降( P <0.05),研究组治疗后24 h、72 h 的 OI、MAP 显著高于对照组, Scr 显著低于对照组( P <0.05)。治疗后3 d 和7 d 两组 SOFA 评分均显著下降,研究组 SOFA 评分显著低于对照组( P<0.05)。结论脓毒血症合并急性肾损伤患者采用 NMRC - DHP 联合 CVVH 治疗能有效清除炎症介质,保护脏器功能,有助于肾功能的早期恢复。
目的:探討中性大孔徑樹脂血液灌流(NMRC - DHP)聯閤連續性靜脈-靜脈濾過(CVVH)對膿毒血癥閤併急性腎損傷患者白介素6(IL -6)、腫瘤壞死因子α(TNF -α)水平及器官功能的影響。方法選擇膿毒血癥閤併急性腎損傷患者共46例,隨機分為研究組和對照組(各23例),研究組行 NMRC - DHP + CVVH 治療,對照組隻進行 CV-VH。通過序貫器官衰竭評分(SOFA)、氧閤指數(OI)、平均動脈壓(MAP)以及血清白介素6(IL -6)和腫瘤壞死因子α(TNF -α)的水平變化,評價兩者在對膿毒血癥閤併急性腎損傷患者的療效。結果治療後24 h 和治療後72 h,兩組血清 IL -6和 IL -10水平較治療前均齣現瞭顯著下降( P <0.05),研究組治療後顯著低于對照組( P <0.05)。治療後兩組 OI 和 MAP 齣現顯著上升,Scr 齣現明顯下降( P <0.05),研究組治療後24 h、72 h 的 OI、MAP 顯著高于對照組, Scr 顯著低于對照組( P <0.05)。治療後3 d 和7 d 兩組 SOFA 評分均顯著下降,研究組 SOFA 評分顯著低于對照組( P<0.05)。結論膿毒血癥閤併急性腎損傷患者採用 NMRC - DHP 聯閤 CVVH 治療能有效清除炎癥介質,保護髒器功能,有助于腎功能的早期恢複。
목적:탐토중성대공경수지혈액관류(NMRC - DHP)연합련속성정맥-정맥려과(CVVH)대농독혈증합병급성신손상환자백개소6(IL -6)、종류배사인자α(TNF -α)수평급기관공능적영향。방법선택농독혈증합병급성신손상환자공46례,수궤분위연구조화대조조(각23례),연구조행 NMRC - DHP + CVVH 치료,대조조지진행 CV-VH。통과서관기관쇠갈평분(SOFA)、양합지수(OI)、평균동맥압(MAP)이급혈청백개소6(IL -6)화종류배사인자α(TNF -α)적수평변화,평개량자재대농독혈증합병급성신손상환자적료효。결과치료후24 h 화치료후72 h,량조혈청 IL -6화 IL -10수평교치료전균출현료현저하강( P <0.05),연구조치료후현저저우대조조( P <0.05)。치료후량조 OI 화 MAP 출현현저상승,Scr 출현명현하강( P <0.05),연구조치료후24 h、72 h 적 OI、MAP 현저고우대조조, Scr 현저저우대조조( P <0.05)。치료후3 d 화7 d 량조 SOFA 평분균현저하강,연구조 SOFA 평분현저저우대조조( P<0.05)。결론농독혈증합병급성신손상환자채용 NMRC - DHP 연합 CVVH 치료능유효청제염증개질,보호장기공능,유조우신공능적조기회복。
Objective To explore the effect of NMRC - DHP combined with continuous venous - venous hemofiltration(CVVH)on lev-els of IL - 6 and TNF - α and impact on organ function in treatment of patients with sepsis complicated with acute renal impairment. Methods A total of 46 patients with sepsis and acute renal impairment were selected and randomly divided into study group and control group(23 cases in each group). Patients in study group were given with NMRC - DHP plus CVVH,and patients in control group were only given with continuous ve-nous - venous hemofiltration(CVVH). The effect of treatment with NMRC plus CVVH in patients with sepsis and acute renal impairment was e-valuated by sequential organ failure assessment(SOFA),oxygenation index(OI),mean arterial pressure(MAP)and changes in serum levels of interleuKin - 6(IL - 6)and tumor necrosis factor - α(TNF - α). Results Serum levels of IL - 6 and IL - 10 in patients of these 2 groups at 24 h and 72 h after treatment had significantly declined in comparison with those before treatment. In patients of study group after treatment,those levels were significantly lower than those of control group. After treatment,OI and MAP in patients of these two groups were significantly increased and Scr was significantly declined. OI and MAP in patients of study group at 24h and 72h after treatment were significantly higher than those of pa-tients in control group,and Scr in study group was significantly lower than that of control group. SOFA scores in patients of these 2 groups at 3d and 7d after treatment were significantly decreased. SOFA scores in study group were significantly lower than those of control group. Conclusion The application of NMRC - DHP combined with CVVH in treatment of patients with sepsis complicated with acute renal impairment can effec-tively remove inflammatory mediators,protect organ function and contribute to the early recovery of their renal function.