采用聚丙烯腈膜滤器行高容量血液滤过在复杂性急性肾功能衰竭血液净化治疗中的临床观察  

Clinical Observation on High Volume Hemofiltration by Using AN69 Polyacrylonitrile Membrane in Treatment of Patients with Complicated Acute Renal Failure

作　　者：杨铁城[1] 伍强[1] 袁丽萍[1] 张树新 

机构地区：[1]深圳市第四人民医院肾内科,广东深圳518033

出　　处：《四川省卫生管理干部学院学报》2007年第2期81-82,112,共3页Journal of Sichuan Continuing Education College of Medical Sciences

基　　金：广东省卫生厅课题(项目编号:A2003731)

摘　　要：目的:观察采用AN69膜滤器行高容量血液滤过(HVHF)在复杂性急性肾功能衰竭(ARF)患者中对血中TNF-α、IL-6的清除及治疗作用。方法:26例复杂性ARF患者,分成2组,16例行HVHF(HVHF组),10例行间歇性血液透析(IHD组),分别测定治疗前和治疗1h、2h、4h、6h、8h时血浆TNF-α、IL-6水平,比较治疗中血压变化和转归预后情况。结果:①HVHF组治疗后4h血浆TNF-α(81.76±26.31pg/ml)、IL-6(86.23±21.35 pg/ml)较治疗前(128.33±25.36 pg/ml)、(146.36±36.25 pg/ml)明显下降(P<0.05);IHD组治疗4h血浆TNF-α(126.56±28.62pg/ml)、IL-6(147.52±30.48pg/ml)较治疗前(129.78±27.56pg/ml)、(152.32±32.63pg/ml)无明显变化(P>0.05)。②HVHF组在治疗过程中血压无明显变化,IHD组在治疗后血压较治疗前明显降低。③HVHF组14/16例I、HD组7/10例存活,肾功能恢复正常。结论:使用AN69膜滤器行HVHF能有效地清除复杂性ARF患者血浆中的TNF-α、IL-6,患者的血流动力学稳定,有利于改善患者的预后。Objectives：To investigate the effect of high volume hemofiltration（HVHF） by using AN69 membrane fdter on serum level of TNF- α, IL- 6 and its clinical action in the treatment of patients with complicated acute renal failure. Methods： 26 cases of complicated acute renal failure were divided into two groups, in which 16 cases underwent HVHF （HVHF group） and 10 cases received intermittent bemodialysis. The pre- and during - treatment （ 1hr,2hr, 4hr,6hr,8hr） ,the serum levels of TNF- α and IL- 6 were examined, and the fluctuation of blood pressure during treatment and the prognosis of patients were observed in the two groups. Results： （1）The serum level of TNF- α 181.76 ± 26.31pg/ml） and IL - 6186.23 ±21.35pg/ml） at the 4th hour during treatment dropped down remarkably comparing to those of pre - treatment （TNF-α 128.33 ±25.36pg/ml, IL- 6 146.36 ±36.25pg/ml）in the HVHF group（ P 〈 0.05）. In the IHD group, there was not significant difference between the serum level of TNF-α（ 126.56 ± 28.62pg/ml） and IL- 6（ 147.52 ±30.48pg/ml） at the 4th hour during treatment and those of pre- treatment（TNF-α 129.78 ± 27.56pg/ml, IL-6 152.32± 32.63pg/ ml）. （2）There was not obvious fluctuation of blood pressure during treatment in the HVHF group, while the blood pressure decreased remarkably after treatment in the IHD group.Q14 out of 16 cases in the HVHF group and 7 out of 10cases in the IHD group vecovered with normalization of renal function. Conclusions： HVHF by using AN69 membrane filter can eliminate serum TNF-α and IL- 6 effectively in patients with complicated acute renal failure. It also can stabilize hemodynamic status and improve prognosis of patients.

关 键 词：高容量血液滤过 聚丙烯腈膜 急性肾功能衰竭 肿瘤坏死因子-Α 白细胞介素-6 

分 类 号：R692.5[医药卫生—泌尿科学]