腹腔脓毒性休克患者血浆Apelin水平在持续肾脏替代治疗前后的变化研究  

Change of plasma Apelin concentration in patients with intraabdominal septic shock before and after CRRT

作　　者：张明[1] 童静[2] 郭献阳[2] 陈如杰[1] 戴凌燕[1] 金盛威[1] 应斌宇[1] 范小芳[3] 龚永生[3] 

机构地区：[1]温州医学院附属第二医院重症医学科,浙江温州325027 [2]温州医学院附属第二医院重症医学科心,浙江温州325027 [3]温州医学院附属第二医院机能实验教学中心,浙江温州325027

出　　处：《中华医院感染学杂志》2013年第2期254-256,共3页Chinese Journal of Nosocomiology

基　　金：温州市科技局项目(Y20100064)

摘　　要：目的观察腹腔脓毒性休克患者血浆Apelin水平在持续肾脏替代治疗(CRRT)前后的变化并探讨其临床意义。方法入选34例腹腔脓毒性休克患者(IN组),临床上随机分为常规治疗(IN 1组)及常规治疗+CRRT(IN 2组),分别在治疗前、治疗后24、48h经肘静脉途径采血;同期17例健康志愿者为对照组(NC组),用放免法测定血浆Apelin水平。结果与NC组比较,IN组血浆Apelin水平在A点有明显升高(P<0.01);在IN1组内,与A点比较,在B点血浆Apelin水平有下降趋势(P>0.05),在C点血浆Apelin水平下降明显(P<0.01);与B点比较,C点血浆Apelin水平下降明显(P<0.05);在IN2组内,与A点比较,在B点血浆Apelin水平有显著下降(P<0.01),在C点血浆Apelin水平下降明显(P<0.01);与B点比较,C点血浆Apelin水平有下降趋势(P>0.05);与IN 1组比较,IN 2组血浆Apelin水平在B点有显著下降(P<0.01),在C点有下降趋势(P>0.05);IN组患者血浆Apelin水平与脑钠肽(BNP)水平有相关性(r=0.466,P<0.05),与血白细胞计数有负相关性(r=-0.593,P<0.05)。结论腹腔脓毒性休克患者血浆Apelin水平升高,经CRRT后能显著降低;血浆Apelin浓度与脑钠肽及血白细胞计数水平相关,提示血浆Apelin参与腹腔脓毒性休克的病理生理过程,对评估病情危重程度有一定的临床意义。OBJECTIVE To observe the change of plasma Apelin in patients of intraabdominal septic shock before and after continuous renal replacement therapy （CRRT） and to explore its potential clinical significance in pathogenesis of intraabdominal septic shock. METHODS A total of 34 patients who were diagnosed as the intraabdominal septic shock（IN group） were enrolled in the study and were clinically randomly divided into the regular treatment（IN1 group） and regular treatment＋CRRT（IN2 group） ; the blood were respectively collected via vein at 24 hours and 48 hours before and after the CRRT 24hours and after CRRT 48hours. Totally 17 healthy volunteers as the normal control（NC group） were enrolled in the study,and the concentration of plasma Apelin was measured by radioimmunoassay. RESULTS The concentration of plasma Apelin in the IN group was significantly increased as compared with the NC group（P〈0.01） ;in the IN1 group, compared with A, the plasma Apelin level was decreased at B（P〉0.05）and was significantly decreased at C（P〈0.01）; as compared with B, the plasma Apelin level was significantly decreased at C （P〈0.05） ;in IN2 group, compared with A, the plasma Apelin level was significantly decreased at B（P〈0.01）and was significantly decreased at C（P〈0.01） ;were descent tendency at C compared with B（P〉0.05） ; as compared with B, the plasma Apelin level was decreased at C（P〉0.05） ; as compared with the IN1 group, the plasma Apelin concentration of the IN2 group was significantly decreased at B （P〈0.01） and was decreased at C （P〉0.05） ; in the IN group the plasma Apelin concentration was positively correlated with the level of brain natriuretic peptide（BNP） （ r=0. 466, P〈0.05） and was negatively correlated with the leukocyte count（r= -0. 593, P〈0.05） . CONCLUSION The level of plasma Apelin is elevated in the patients with intraabdominal septic shock and is significantly decreased after CRRT; the plasma Apelin concentration is corr

关 键 词：脓毒性休克 持续肾脏替代治疗 腹腔感染 

分 类 号：R446.1[医药卫生—诊断学]