HVHF联合HP治疗恙虫病合并多器官功能衰竭疗效研究  

Effect of high-volume hemofiltration combined with hemoperfusion on tsutsugamushi disease patients accompanied with multiple organ failure

作　　者：谢潮鑫[1] 孟猛[1] 江美仪[1] 

机构地区：[1]解放军第421医院肾内科,广东广州510310

出　　处：《中国热带医学》2011年第6期758-760,共3页China Tropical Medicine

摘　　要：目的探讨高容量血液滤过(HVHF)联合血液灌流(HP)对恙虫病合并多器官功能衰竭(MOF)的疗效。方法回顾性分析解放军421医院2004～2009年行HVHF联合HP治疗恙虫病合并MOF的24例患者,按治疗转归分死亡组和存活组,对比分析两组的血浆内皮素(ET),并将HVHF联合HP治疗前和治疗24h后的血肌酐(Cr)、尿素氮(BUN)、氧合指数、乳酸、平均动脉压(MAP)、APACHE II评分等结果进行比较。结果 (1)死亡组ET明显高于存活组。(2)两组治疗24h后Cr、BUN、氧合指数、乳酸、MAP均明显改善;存活组APACHE II评分显著降低,死亡组无明显变化。结论 HVHF联合HP可有效辅助治疗恙虫病合并MOF;ET对判断恙虫病合并MOF的预后有指导意义。Aim To investigate the prognosis of tsutsugamushi disease patients accompanied by multiple organ failure （MOF） using high-volume hemofitratian（HVHF） combined with hemoperfusion（HP）. Methods There 24 tsutsugamushi disease patients accompanied by MOF treated with HVHF combined with HP in the period from Jan.2004 to Jan.2009.17 patients were divided into survival group and non-survival group based on outcome. The serum endothelin （ET） levels in the two groups were compared. The levels of serum creatinine,blood urea nitrogen （BUN）,oxygenate index,lactic acid,mean arterial pressure, APACHE II score were also compared before and after HVHF combined with HP for 24 hours. Results The serum ET level was significantly higher in non-survival group than that in survival group （P〈0.01）; After HVHF combined with HP for 24h,the levels of serum creatinine,BUN,oxygenate index,lactic acid and mean arterial pressure improved significantly in two groups. APACHE II score decreased significantly in survival group,but insignificantly in non-suvival group. Conclusion HVHF combined with HP is an effective measure for treatment of tsutsugashi disease patients accompanied by MOF. ET is useful for the prognosis prediction of tsutsugashi disease patients accompanied by MOF.

关 键 词：高容量血液滤过 血液灌流 恙虫病 多器官功能衰竭 APACHE Ⅱ评分 内皮素 

分 类 号：R513.2[医药卫生—内科学]