连续性血液滤过对脓毒症患者细胞因子表达的影响  

Continuous Hemofiltration on Factors Affecting the Expression of the Cells in Patients with Sepsis

作　　者：杨蕙文[1] 喻秋平[1] 叶兴文[1] 李力[1] 刘松[1] 

机构地区：[1]九江学院附属医院ICU,江西九江332000

出　　处：《黑龙江医学》2015年第7期751-753,共3页Heilongjiang Medical Journal

基　　金：江西省卫生厅科技项目课题(20157096)

摘　　要：目的探讨连续性血液滤过(CRRT)对脓毒症患者细胞因子表达的影响。方法将我院重症医学科收住院的28例脓毒症患者分为实验组和对照组,在相同的综合治疗基础上,实验组给予CRRT治疗,持续治疗72 h。记录两组患者治疗前后急性生理学与慢性健康状况评分(APACHEⅡ评分)、血流动力学指标及炎症感染指标。二组患者分别于治疗前和治疗后24 h、治疗后48 h、治疗后72 h各时点抽取外周静脉血,应用酶吸附法测定白细胞介素-1(IL-1)、白细胞介素-10(IL-10)及肿瘤坏死因子-α(TNF-α)水平。结果实验组治疗后72h APACHEⅡ评分、平均动脉压、C反应蛋白、降钙素原均较治疗前有所改善(P<0.05);与对照组比较,实验组APACHEⅡ评分、C反应蛋白、降钙素原均显著降低,差异具有统计学意义(P<0.05);与对照组比较,实验组各时点血清、IL-1、TNF-α水平均显著下降,差异具有统计学意义(P<0.05);IL-10水平较治疗前明显升高(P<0.05),且与同期常规治疗组比较差异均有统计学意义(P<0.05)。结论 CRRT技术能有效地清除脓毒症患者血清细胞因子,维持血流动力学稳定,从而可以提高其临床疗效。Objective To investigate continuous hemofiltration（ CRRT） effect on the expression of cytokine levels in patients with sepsis. Methods 28 sepsis hospitalized patients in ICU in the hospital were divided into experimental group and control group. On the basis of comprehensive treatment,the experimental group received CRRT treatment with 72 h continued treatment. Acute physiology and chronic health evaluation（ APACHE Ⅱ score）,hemodynamic parameters and indicators of inflammation and infection venous blood of the two groups before and after the treatment were recorded. Interleukin- 1（ IL- 1）,interleukin- 10（ IL- 10） and tumor necrosis factor- α（ TNF- α） levels were measured by enzyme assay. Results In the experimental group,APACHEⅡ score,mean arterial pressure,C-reactive protein,procalcitonin after 72 h treatment improved compared with those before treatment（ P〈0. 05）; Compared with the control group,APACHEⅡ score,C-reactive protein and procalcitonin in the experimental group were significantly lower,and the difference was statistically significant（ P〈0. 05）; compared with the experimental group,serum,IL- 1 and TNF- α levels were significantly decreased,and the difference was statistically significant（ P〈0. 05）. IL- 10 levels significantly increased than before treatment（ P〈0. 05）,and through the comparison with the same period in the conventional treatment group,differences were statistically significant（ P〈0. 05）.Conclusion CRRT technology can effectively remove serum cytokines in patients with sepsis,and maintain hemodynamic stability,which can improve its clinical efficacy.

关 键 词：脓毒症 连续性血液滤过 细胞因子表达 

分 类 号：R459.7[医药卫生—急诊医学]