全血吸附并联连续性静脉静脉血液滤过治疗全身炎症反应综合征疗效观察  

Observation on efficacy of absorption combined with continuous venovenous hemofiltration for treatment of patients with systemic inflammatory response syndrome

作　　者：薛丽娜[1,2] 缪立英[1,2] 朱滨[1,3] 刘金凤[1,2] 金丽娜[1,2] 何小舟[1,2] 

机构地区：[1]苏州大学附属第三医院 [2]常州市第一人民医院血液净化中心,213003 [3]常州市第一人民医院重症医学科,213003

出　　处：《齐齐哈尔医学院学报》2013年第15期2193-2195,共3页Journal of Qiqihar Medical University

基　　金：江苏省常州市卫生局基金资助(wz201008)

摘　　要：目的探讨全血吸附(AP)并联连续性静脉静脉血液滤过(CVVH)治疗全身炎症反应综合征(SIRS)患者的临床疗效和安全性。方法 63例SIRS患者随机分为治疗组(31例,AP并联CVVH方法)和对照组(32例,单纯CVVH方法),比较两组患者治疗前后血清炎症介质肿瘤坏死因子(TNF)、C反应蛋白(CRP)、白细胞介素(IL-1、IL-6、IL-10)的变化和急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分,同时观察治疗后不良反应,并进行组内和组间统计学比较。结果治疗组治疗50 h后TNF、CRP、IL-1、IL-6和IL-10数值呈下降趋势,数值变化和治疗前及对照组比较差异有统计学意义(P<0.05);治疗组治疗50 h后APACHEⅡ评分呈下降趋势,数值变化与治疗前比较差异有统计学意(P<0.05),与对照组比较差异无统计学意义(P>0.05);治疗组未发生出血、休克、过敏、血小板减少等严重并发症。结论 AP并联CVVH能有效降低SIRS患者血清炎性介质水平,改善患者预后,疗效优于单纯CVVH,且无明显不良反应。Objective To evaluate efficacy and safety of absorption（AP） combined with continuous venovenous hemofiltration（CVVH） for treatment of patients with systemic inflammatory response syndrome（SIRS）.Methods Randomly,63 patients of SIRS were divided into two groups,31 cases in the treatment（AP combined with CVVH） and 32 cases in the control（CVVH）,serum levels of inflammatory mediators（TNF,CRP,IL-1,IL-6 and IL-10） and acute physiology and chronic health evaluation Ⅱ（APACHE Ⅱ） score were recorded before and after the treatment,therapy-related adverse reactions were evaluated,followed by statistical comparison within and between the groups.Results We observed statistically significant decreases（P〈0.05） in the treatment group of the serum levels of inflammatory mediators（TNF,CRP,IL-1,IL-6 and IL-10） and the APACHE Ⅱ score,50h after the treatment.Secondly,the serum levels of inflammatory mediators in the treatment group statistically reduced（P〈0.05）,compared with the control group.No therapy-re1ated adverse reactions,including severe hemorrhage,shock,hypersensitivity and thrombocytopenia were noted.Conclusions AP combined with CVVH can effectively clean the serous inflammatory mediators for SIRS patients,its therapeutic effect is superior to mere CVVH and no untoward side effects seen in the course of the treatment.

关 键 词：全血吸附 连续性静脉静脉血液滤过 全身炎症反应综合征 

分 类 号：R473.5[医药卫生—护理学]