连续性血液净化对严重脓毒症患者内皮细胞功能的影响  

Effect of continuous blood purification on endothelial cell function in patients with severe sepsis

作　　者：杨群[1] 许兆军[1] 杨素华 蔡宝祥[3] 

机构地区：[1]宁波市第二医院ICU,浙江宁波315000 [2]浙江省温州市苍南县妇幼保健院,浙江苍南325800 [3]宁波市医疗中心李惠利医院皮肤科,浙江宁波315040

出　　处：《中国现代医生》2012年第17期34-36,共3页China Modern Doctor

基　　金：浙江省温州市科技计划项目(Y20090249)

摘　　要：目的探讨连续性血液净化对严重脓毒症患者内皮细胞功能的影响。方法 65例脓毒症患者随机分为CBP组和对照组,均给予集束化治疗,CBP组配合连续性血液净化治疗。结果 CBP组机械通气时间、ICU住院时间均显著少于对照组(P<0.05),28 d生存率则显著高于对照组(P<0.05)。CBP组治疗24 h后APACHEⅡ、vWF、sICAM-1、TM水平均显著低于对照组(P<0.05),24 h后APC水平显著高于对照组(P<0.05),vWF、sICAM-1、TM水平与APACHEⅡ评分呈正相关(P<0.05),APC水平与APACHEⅡ评分呈负相关(P<0.05)。治疗24 h开始存活组vWF、sICAM-1、TM水平均显著低于死亡组,APC水平显著高于死亡组(P<0.05)。结论 CBP治疗对严重脓毒症患者的内皮细胞功能有保护作用,改善转归和预后。Objective To investigate the effect of continuous blood purification on endothelial cell function in patients with severe sepsis. Methods Sixty-five cases of sepsis patients had been randomly divided into the CBP group and control group had been given cluster treatment, CBP group with the continuous blood purification. Results In CBP group, mechanical ventilation time, ICU length of stay were significantly less than the control group（P 〈 0.05）, 28 d survival rate was significantly higher （P 〈 0.05）. CBP group after therapy for 24 hours, the APACHE Ⅱ and vWF, sICAM-Ⅰ, TM level were significantly lower than the control group （P 〈 0.05）, and APC level was significantly highe （P 〈 0.05）, and vWF, sICAM-1, TM levels were positively correlated with the APACHE II score （P 〈 0.05）, the APC level and the APACHE Ⅱ score was negative correlation （P 〈 0.05）. After therapy for 24 hours, vWF, sICAM-1 and TM of survival group were significantly lower than death group, and the APC of survival group was significantly higher than death group （P 〈 0.05）. Conclusion CBP has a protective effect on endothelial function in patients with severe sepsis and improve outcome and prognosis.

关 键 词：脓毒症 连续性血液净化 内皮细胞 

分 类 号：R459.5[医药卫生—治疗学]