连续性静-静脉血液滤过治疗对重症急性肾损伤患者血清细胞因子的影响  

Effects of continuous veno-venous hemof＇dtration therapy on serum cytokines in patients with acute kidney injury

作　　者：宋洁[1] 孟庆勇[1] 李瑛[1] 李辉[1] 张晓东[1] 

机构地区：[1]武警后勤学院附属医院肾脏病科,天津300162

出　　处：《中国急救复苏与灾害医学杂志》2013年第3期226-228,共3页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：天津市自然科学基金面上项目（09JCYBJC09900）

摘　　要：目的探讨连续性静-静脉血液滤过治疗（CVVH）对重症急性肾损伤（AKI）患者血浆细胞因子的影响。方法重症AKI患者68例均接受CVVH治疗，并选择同期健康体检者30例为对照组。于CVVH治疗前和治疗1h、3h、6h、12h、24h各时间点采用酶联免疫吸附法检测AKI患者血清中肿瘤坏死因子-α（TNF-α）、白介素-1β（IL-1β）、白介素-6（IL-6）、白介素-8（IL-8）水平的变化。结果AKI患者CVVH治疗前血清细胞因子TNF—α、IL-1β、IL-6、IL-8水平均显著高于对照组（均P〈0．05）。经CWH治疗后，AKI患者在治疗1h时血清TNF-α、IL-1β、IL-6、IL-8浓度开始下降，3h时下降明显（均P〈0．05），6h时浓度降至最低，12。24h间浓度略有升高，但仍显著低于治疗前（均P〈0．05）。结论CVVH治疗可有效清除AKI患者血清中炎症细胞因子TNF-α、IL-1β、IL-6、IL-8，有助于阻断全身炎症反应，改善急性肾衰竭患者预后。Objective To investigate the effects of continuous veno-venous hemofiltration （CVVH） on the serum cytokines in the patients with acute renal failure （AKI）. Methods 68 AKI patients underwent CVVH （AKI group） and 30 healthy people were used as the control group. The serum concentrations of tumor necrosis factor （TNF）-α, IL-1β, IL-6, and IL-8 were measured using specific enzyme-linked immunosorbent assays （ELISA） before and 1 hour, 3 hours, 6 hours, 12 hours, and 24 hours after CVVH. Results Before the treatment the serum levels of TNF-α, IL-1β, IL-6, and IL-8 of the AKI group were all significantly higher than those of the control group （all P〈0.05）. Since 1 hour after the CVVH treatment, the serum levels of TNF-α, IL-1β, IL-6, and IL-8 in the AKI group bean to decrease significantly （all P〈0.05）, and decreased to the lowest points 6 hours after the CVVH treatment （all P〈0.05）. Then the serum levels of TNF-α, IL-1β, IL-6, and IL-8 increased slightly 12 hours and 24 hours after the CVVH treatment, yet still were significantly lower than those before the CVVH treatment （all P〈0,05）. Conclusion CVVH treatment decreases effectively the production of TNF-α, IL-1β, IL-6, and IL-8, and is an important therapeutic method for improving the prognosis of patients with AKI.

关 键 词：连续性肾脏替代疗法 连续性静-静脉血液滤过 急性肾损伤 细胞因子 

分 类 号：R692[医药卫生—泌尿科学]