连续性血液滤过对多器官功能障碍患者炎性介质的影响  

Effect of Continuous Hemofiltration on Inflammatory Mediator in Multi-organ Dysfunction Syndrome Patients

作　　者：刘恩波[1] 牛效清[2] 宋艳玲[1] 李振海[2] 

机构地区：[1]广东省深圳市罗湖区人民医院肾内科,518001 [2]黑龙江省佳木斯大学附属第一医院肾内科,154002

出　　处：《实用全科医学》2007年第10期885-886,共2页Applied Journal Of General Practice

摘　　要：目的探讨连续性静脉-静脉血液滤过(CVVH)在治疗多器官功能障碍综合征(MODS)患者过程中对其炎性介质的影响。方法选择30例危重患者,诊断符合MODS标准,分为实验组和对照组;实验组进行常规综合治疗和CVVH治疗,对照组患者采用常规综合治疗,观察2组患者血液及滤液中的白介素-1(IL-1β)、肿瘤坏死因子(TNF-a)、C反应蛋白(CRP)的变化。结果实验组CVVH前后IL-1β无变化(P>0.05),血TNF-a、CRP在CVVH后呈降低趋势(P<0.01);临床症状也明显改善;对照组无明显变化,且有轻度升高。结论对MODS患者应用CVVH治疗,可以清除炎症介质,减少其对组织器官的损害;并通过稳定内环境,调节水、电解质及酸碱平衡,进而达到改善临床症状提高生存率的目的。Objective To explore the effect of continuous vein-vein hemofiltration（CVVH） on inflammatory mediator during treatment of Multi-organ Dysfunction Syndrome（MODS） Patients. Methods 30 severe patients who can fit the diagnostic criteria of MODS were divided into experimental group and control group randomly. Control group patients were treated conventionally. Experimental group patients were treated with conventional method and CVVH. The change of serum interleukin-1β （ IL-1β）, Tumor Necrosis Factor-α（TNF-α） and C-reactive protein（CRP） were analyzed. Results The serum IL-1β level had no change while serum TNF-αand CRP decreased markedly（ P 〈0.01 ） after CVVH in experimental group. Severity of clinical features also decreased obviously. In control group, serum IL-113,TNF-α, CRP and severity of clinic features had no markedly change, but increased slightly. Conclusions CVVH can remove inflammatory mediator by which to inhibit organ injury and can maintain home- ostasis,regulate volume,electrolyte and acido-base balance by which to increase survival rate in MODS patients.

关 键 词：连续性静脉-静脉血液滤过 多器官功能障碍 炎症介质 

分 类 号：R459.5[医药卫生—治疗学]