配对血浆滤过吸附治疗对MODS患者肿瘤坏死因子-α及其受体的影响  

作　　者：高波[1] 刘昌华[1] 魏丛军[1] 林华[1] 徐道亮[1] 

机构地区：[1]扬州大学附属苏北医院,225001

出　　处：《浙江临床医学》2009年第12期1270-1272,共3页Zhejiang Clinical Medical Journal

摘　　要：目的研究配对血浆滤过吸附（coupled plasma filtration adsorption，CPFA）治疗多脏器功能障碍综合征（multiple organ dysfunction syndromes，MODS）患者肿瘤坏死因子-α（TNF-α）及其受体的影响。方法MODS患者24例，随机分为对照组与治疗组，各12例，两组患者均在常规药物治疗基础上分别予以连续性静脉-静脉血液滤过（CVVHF）治疗与CPFA治疗12h。检测治疗后不同时间TNF-α及可溶性肿瘤坏死因子受体1和受体2（sTNF—R1，sTNF—R2）的变化。结果CVVHF组治疗4h后TNF-α开始降低，与治疗前比较差异有统计学意义（P〈0．05），6h降至最低水平，sTNF—R，及sTNF—R，的变化不明显；CPFA组2h后TNF—α开始降低，随后持续降低，sTNF—R1和sTNF—R2分别在治疗后8h及10h开始增高，与治疗前比较差异有统计学意义（P〈0．05）。结论CPFA能降低降低MODS患者TNF-α水平，并能提高sTNF—R1、sTNF—R2水平，清除炎症介质优于CVVHF。Objective To investigate the effect of coupled plasma filtration adsorption （CPFA） on tumor necrosis factor - α （TNF -α） and soluble tumor necrosis factor receptor 1 and 2 （sTNF- R1, sTNF- R2 ） in patients with multiple organ dysfunction syndromes （MODS）. Methods 24 patients diagnosed as MODS were randomly divided into control group and treating group （ CPFA group）. The control group based on the conventional drug treatment had the treatment of continuous veno -venous hemofiltration （CVVHF） for 12 hours. The treating group was disposaled in the method of CPFA for 12 hours. Serum levels of TNF - α and soluble tumor necrosis factor receptor 1 and 2 （ sTNF - R1 , sTNF - R2 ） were detected at different time points. Results The contents of TNF-α in the CVVHF group tended to decrease at 4h and it reached to the peak at 6h. Compared to prior treatment, there was significant difference（ P 〈 0. 05 ）; the changes of sTNF- R1 and sTNF- R2 were not significant; the contents of TNF-α in the CPFA group tended to decrease at 2h and it kept on decreasing, sTNF - R1 and sTNF - R2 started to increase diseriminately at 8h and 10h. There was significant difference（ P 〈0. 05 ） in their level compared to prior treatment. Conclusions CPFA treatment is superior to CVVHF in decreasing the level of TNF - α and increasing sTNF - R1 and sTNF - R2 in MODS patients.

关 键 词：配对血浆滤过吸附 多器官功能障碍综合征 肿瘤坏死因子-Α 

分 类 号：R735.104[医药卫生—肿瘤] R692.5[医药卫生—临床医学]