CAJ | 학술논문

目的：探讨连续性血液透析和间歇性血液透析联合血液灌流在治疗重症急性胰腺炎并发急性肾损伤过程中对白细胞介素‐1（IL‐1）和肿瘤坏死因子（TNF）清除率的差异性。方法回顾性分析泸州市人民医院收治的重症急性胰腺炎并发急性肾损伤患者34例，其中连续性血液透析24例，间歇性血液透析联合血液灌流10例，调查患者性别、年龄、治疗前急性生理学与慢性健康状况评分Ⅱ（APACHE‐Ⅱ）、急性肾损伤分级；统计不同透析方式在血液透析治疗开始前和血液透析治疗结束时外周静脉血IL‐1和T N F的数值，分别比较2种透析方式对两种指标清除率的差异性。结果两组患者在年龄、急性肾损伤分级、APACHE‐Ⅱ评分等指标上差异无统计学意义（P＞0．05）；两组在血液透析治疗前IL‐1和TNF的测值差异无统计学意义（P＞0．05）；两组在血液透析治疗结束时IL‐1和TNF的测值差异有统计学意义（P＜0．05）。结论连续性血液透析对大分子物质的清除率优于间断性血液透析联合血液灌流。
목적：탐토련속성혈액투석화간헐성혈액투석연합혈액관류재치료중증급성이선염병발급성신손상과정중대백세포개소‐1（IL‐1）화종류배사인자（TNF）청제솔적차이성。방법회고성분석로주시인민의원수치적중증급성이선염병발급성신손상환자34례，기중련속성혈액투석24례，간헐성혈액투석연합혈액관류10례，조사환자성별、년령、치료전급성생이학여만성건강상황평분Ⅱ（APACHE‐Ⅱ）、급성신손상분급；통계불동투석방식재혈액투석치료개시전화혈액투석치료결속시외주정맥혈IL‐1화T N F적수치，분별비교2충투석방식대량충지표청제솔적차이성。결과량조환자재년령、급성신손상분급、APACHE‐Ⅱ평분등지표상차이무통계학의의（P＞0．05）；량조재혈액투석치료전IL‐1화TNF적측치차이무통계학의의（P＞0．05）；량조재혈액투석치료결속시IL‐1화TNF적측치차이유통계학의의（P＜0．05）。결론련속성혈액투석대대분자물질적청제솔우우간단성혈액투석연합혈액관류。
Objective To investigate the differences of clearance rate of interleukin‐1(IL‐1) and tumor necrosis factor (TNF) between continuous hemodialysis and intermittent hemodialysis (IHD) combined with hemoperfusion in the treatment process of severe acute pancreatitis (SAP) complicating acute kidney injury (AKI) .Methods To retrospectively analyze 34 cases of SAP complicated with acute kidney injury in our hospital ,including 24 cases of continuous hemodialysis and 10 cases of intermittent hemodialysis combined with hemoperfusion .The gender ,age ,a‐cute physiology and chronic health evaluation score Ⅱ (APACHE‐Ⅱ ) ,acute kidney injury grade were investigated ;the peripheral blood IL‐1 and TNF values before and after hemodialysis therapy in different dialysis modes were per‐formed the statistical analysis .The differences of clearance rates of two indexes were compared between the two dial‐ysis modes .Results There was no statistically significant differences in the indexes of age ,acute renal injury grade and APACHE‐Ⅱ score between two groups (P>0 .05);the values of IL‐1 and TNF before hemodialysis treatment had no statistical differences between the two groups(P>0 .05);the values of IL‐1 and TNF at the end of hemodialy‐sis treatment had statistical differences between the two groups .Conclusion The continuous hemodialysis is superior to the intermittent hemodialysis combined with hemoperfusion in the clearance rate of macromolecular substances .