微循环学杂志
微循環學雜誌
미순배학잡지
CHINESE JOURNAL OF MICROCIRCULATION
2015年
2期
52-54,57
,共4页
血液灌流%血液滤过%高脂血症胰腺炎%肾衰竭
血液灌流%血液濾過%高脂血癥胰腺炎%腎衰竭
혈액관류%혈액려과%고지혈증이선염%신쇠갈
Hemoperfusion%Hemofiltration%Hyperlipidaemic acute pancreatitis%Rental failure
目的：：观察血液灌流(HP)联合血液滤过(CVVH)对高脂血症胰腺炎伴肾衰竭患者的疗效。方法：将59例高脂血症伴肾功能损伤患者随机分为两组：A组27例,在常规治疗基础上行 HP+CVVH；B组32例,在常规治疗基础上行CVVH 治疗。比较两组患者治疗前及治疗后48h、治疗后72h血清淀粉酶(AMY)、脂肪酶(LIPA)、甘油三酯(TG)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、血肌酐(Cr)、尿素氮(BUN)水平及急性生理与慢性健康评分(APACHEⅡ)的变化。选取30例健康志愿者作为正常对照组。结果：治疗前,两组上述各指标均显著高于正常对照组(P<0.01),治疗后48h和治疗后72h,所有指标较治疗前明显下降(P<0.01),且治疗后72h 比治疗后48h下降更显著(P<0.05)。与 B 组同时相比较,A 组治疗后48h 及治疗后72h 患者血清 TG、TNF-α、IL-6、Cr、BUN水平及 APACHEⅡ降低更明显(P<0.05)。结论：HP联合CVVH 较单纯CVVH 治疗能够更有效地清除高脂血症胰腺炎并肾功能衰竭患者的炎性介质,从而保护肾功能。临床可选其作为重要辅助治疗手段。
目的：：觀察血液灌流(HP)聯閤血液濾過(CVVH)對高脂血癥胰腺炎伴腎衰竭患者的療效。方法：將59例高脂血癥伴腎功能損傷患者隨機分為兩組：A組27例,在常規治療基礎上行 HP+CVVH；B組32例,在常規治療基礎上行CVVH 治療。比較兩組患者治療前及治療後48h、治療後72h血清澱粉酶(AMY)、脂肪酶(LIPA)、甘油三酯(TG)、腫瘤壞死因子-α(TNF-α)、白介素-6(IL-6)、血肌酐(Cr)、尿素氮(BUN)水平及急性生理與慢性健康評分(APACHEⅡ)的變化。選取30例健康誌願者作為正常對照組。結果：治療前,兩組上述各指標均顯著高于正常對照組(P<0.01),治療後48h和治療後72h,所有指標較治療前明顯下降(P<0.01),且治療後72h 比治療後48h下降更顯著(P<0.05)。與 B 組同時相比較,A 組治療後48h 及治療後72h 患者血清 TG、TNF-α、IL-6、Cr、BUN水平及 APACHEⅡ降低更明顯(P<0.05)。結論：HP聯閤CVVH 較單純CVVH 治療能夠更有效地清除高脂血癥胰腺炎併腎功能衰竭患者的炎性介質,從而保護腎功能。臨床可選其作為重要輔助治療手段。
목적：：관찰혈액관류(HP)연합혈액려과(CVVH)대고지혈증이선염반신쇠갈환자적료효。방법：장59례고지혈증반신공능손상환자수궤분위량조：A조27례,재상규치료기출상행 HP+CVVH；B조32례,재상규치료기출상행CVVH 치료。비교량조환자치료전급치료후48h、치료후72h혈청정분매(AMY)、지방매(LIPA)、감유삼지(TG)、종류배사인자-α(TNF-α)、백개소-6(IL-6)、혈기항(Cr)、뇨소담(BUN)수평급급성생리여만성건강평분(APACHEⅡ)적변화。선취30례건강지원자작위정상대조조。결과：치료전,량조상술각지표균현저고우정상대조조(P<0.01),치료후48h화치료후72h,소유지표교치료전명현하강(P<0.01),차치료후72h 비치료후48h하강경현저(P<0.05)。여 B 조동시상비교,A 조치료후48h 급치료후72h 환자혈청 TG、TNF-α、IL-6、Cr、BUN수평급 APACHEⅡ강저경명현(P<0.05)。결론：HP연합CVVH 교단순CVVH 치료능구경유효지청제고지혈증이선염병신공능쇠갈환자적염성개질,종이보호신공능。림상가선기작위중요보조치료수단。
Objective:To observe the effect of hemoperfusion combined with continue venovenous hemofiltra-tion (CVVH)to the patients of the hyperlipidaemic acute pancreatitis associated with acute rental failure.Method:5 9 patients of the hyperlipidaemic acute pancreatitis associated with rental failure were divide into two groups ran-domly.The basic treatment was used in group A(n=27)associated with the HP+CVVH.The basic treatment was used in group B(n=32)associated with the CVVH.The serum levels of amylase(AMY),lipase(LIPA),triglyceride (TG),tumor necrosis factor-α(TNF-α),lnterleukin-6 (IL-6 ),creatinine (Cr),blood urea nitrogen (BUN)were compared before and at 48 and 72 hour time point after the different treatment.The APACHEⅡscore was also com-pared between each group before and after treatment.Results:Before the treatment all index were higher than the control group.After different treatment all the index were decreased compared with control group at 48 and 72 hour time point (P<0.01).The levels of TG,TNF-α,IL-6,Cr,BUN and APACHEⅡ in group A were lower than that in group B at 48 and 72 time point (P<0.05).Conclusion:The HP+CVVH treatment can remove the inflam-matory medium more effective than the CVVH ,and HP+CVVH can protect the rental function more than the CVVH, thus HP+CVVH can be a very important adj uvant therapy in hyperlipidamic pancreatitis associated with rental failure.
