不同模式血液净化组合对脓毒症血清PCT、hs-CRP及细胞因子的影响  

Influences of the procalcitionin(PCT)and high-sensitivity C-creative protein(hs-CRP)and cell factors to sepsis patients by blood purification mode

作　　者：唐忠平[1] 李春棠[1] 林凤[1] 纪媛[1] 

机构地区：[1]贵阳市第一人民医院重症医学科,贵州贵阳550002

出　　处：《贵州医药》2015年第2期116-119,共4页Guizhou Medical Journal

摘　　要：目的观察脓毒症患者连续静-静脉血液滤过(CVVH)加血浆灌流(PP)或加血液灌流(HP)治疗后,血清肿瘤坏死因子α(TNF-α)、白介素6(IL-6)、白介素1(IL-1)、C-反应蛋白(hs-CRP)、前降钙素原(PCT)浓度的变化,以比较两种血液净化模式的疗效。方法将30例脓毒症患者随机分为PP组及HP组,每组15例,分别于PP或HP治疗2h后行持续CVVH治疗,并分别测定、比较两组患者0h、12h、24h后的APACHE-Ⅱ评分和0h、2h、6h、12h、24h后血清TNF-α、IL-6、IL-1、hs-CRP及PCT的浓度水平。结果治疗后12h、24h两组APACHE-Ⅱ评分均显著降低且PP组均低于HP组(P<0.05);治疗后四个时点两组TNF-α、IL-6、IL-1、hs-CRP及PCT值均降低(P<0.01,P<0.05),其中PP组治疗2h后IL-6、IL-1、PCT及6h后PCT值显著低于HP组(P<0.05)。结论两种血液净化模式对脓毒症血清TNF-α、IL-6、IL-1、hs-CRP及PCT均有一定清除作用。Objective To observe the change of serum tumor necrosis factor‐alpha （TNF‐α） ,Interleukin‐6 （IL‐6） ,Interleukin‐1（IL‐1） ,high‐sensitivity C‐creative protein （hs‐CRP） ,procalcitionin （PCT ） in sepsis patients by blood purification mode PP＋CVVH or HP＋CVVH ,and to compare the effects of two kinds of blood purification . Method Total of 30 cases of sepsis patients were divided randomly into PP group and HP group ,15cases in each group ,were treated with PP or HP treatment for 2 hours and then CVVH treatment .APACHE‐Ⅱ scores on hours 12 ,14 after treatment and the level of sepsis serum IL‐1 ,IL‐6 ,TNF‐α,PCT and hs‐CRP were measured and com‐pared between PP group and HP group .Result APACHE‐Ⅱ scores of two groups were reduced after treatment ,and were lower in PP group than in HP group on hours 12 ,24 after treatment （P〈0 .05） .TNF‐α,IL‐1 ,IL‐6 ,hs‐CRP and PCT were lower in two groups on hours 2 ,6 ,12 ,24 after treatment ,and there were the statistical significantly differences （P〈0 .05） .Among them ,IL‐1 ,IL‐6 ,PCT were lower on hours 2 after treatment and PCT were lower on hours 6 after treatment in PP group than HP group （P〈0 .05） .Conclusion The two kinds of blood purification mode have a certain degree of scavenging effect in the levels of sepsis serum TNF‐α,IL‐6 ,IL‐1 ,hs‐CRP ,PCT and the effect of blood purification mode PP＋CVVH better than HP＋CVVH .

关 键 词：脓毒症 细胞因子 降钙素原 超敏C反应蛋白 持续性血液净化 

分 类 号：R-33[医药卫生] R495.5