连续性血液净化对顽固性心衰患者血浆炎症因子的影响  

Effects on Inflammatory Cytokines in Patients With Refractory Heart Failure by Continuous Blood Purification

作　　者：李旭[1] 刘加明[1] 金鑫[1] 刘春[2] 

机构地区：[1]石河子大学医学院第三附属医院肾病科,新疆石河子832000 [2]石河子大学医学院第一附属医院肾病科,新疆石河子832008

出　　处：《农垦医学》2015年第2期122-126,共5页Journal of Nongken Medicine

基　　金：新疆生产建设兵团第八师石河子市科技计划项目(2013YL09)

摘　　要：目的:探讨连续性血液净化(continuous blood purification,CBP)对顽固性心衰患者血浆炎症因子的影响,并观察其疗效及不良反应。方法:入组顽固性心力衰竭患者40例,根据患者意愿,分为CBP联合常规药物治疗组(CBP组)与常规药物治疗组(常规治疗组),各20例。观察治疗8小时前后肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、白细胞介素8(IL-8)的变化,以及疗效、不良反应。结果:治疗8小时后,CBP组TNF-α、IL-6、IL-8水平较治疗前下降(<0.01),且低于常规治疗组(<0.01);常规治疗组上述指标较治疗前下降,但无统计学意义(>0.05)。治疗8小时后,两组纽约心脏病协会(NYHA)心功能分级改善,但CBP组优于常规治疗组(<0.001)。CBP治疗中有2例出现低血压,未出现出血、栓塞、感染等不良反应。结论:CBP能降低顽固性心衰患者血浆TNF-α、IL-6、IL-8水平,改善心功能,不良反应少。Objective： The effects on plasma inflammatory cytokines,clinical efficacy,adverse reactions of continuous blood purification（CBP） for the treatment of refractory heart failure were evaluated.Methods： Forty refractory heart failure patients were enrolled and assigned into CBP combined with conventional medical treatment group（CBP treatment group,n=20） or conventional medical treatment group（conventional treatment group,n=20）,according to the patient＇s preferences.The tumor necrosis factor alpha（TNF-α）,Interleukin-6（IL-6）,interleukin-8（IL-8） before and after 8 hours of treatment were determined.The clinical efficacy,adverse effects were observed and recorded.Results： After 8 hours of treatment,the plasma concentration of TNF-α,IL-6,IL-8 declined in both group,and these changes were significant in the CBP treatment group when compared with the initial values（P〈0.01）and compared with the conventional treatment group（P〈0.01）,but without statistical significance in the conventional treatment group（P〉0.05）.Improvement in New York Heart Association（NYHA） Functional Classification were observed in both group,and this change was significant in the CBP treatment group when compared with the conventional treatment group（P〈0.001）.Low blood pressure occurred in two patients during the treatment of CBP.Other adverse reactions such as hemorrhage,embolism as well as infection was not found.Conclusions：CBP reduced the plasma concentration of TNF-α,IL-6,IL-8,and improved cardiac function with less side effects in patients with refractory heart failure.

关 键 词：连续性血液净化 顽固性心衰 炎症因子 

分 类 号：R459.5[医药卫生—治疗学]