血液净化治疗对感染性休克患者炎性损伤及氧代谢的影响观察  

Observation of the effect of blood purification therapy on inflammatory injury and oxygen metabolism in patients with septic shock

作　　者：王一凡[1] 曾杰[2] 付晶[1] 许海东 郑君[1] WANG Yi-fan;ZENG Jie;FU Jing;XU Hai-dong;ZHENG Jun(Sichuan Provincial People＇s Hospital,Sichuan Academy of Medical Sciences Chengdu,Sichuan 610000,China)

机构地区：[1]四川省人民医院.四川省医学科学院急诊内科,四川成都610000 [2]四川省人民医院.四川省医学科学院急诊外科,四川成都610000

出　　处：《中华医院感染学杂志》2018年第15期2306-2309,共4页Chinese Journal of Nosocomiology

基　　金：四川省科技厅科技计划基金资助项目(30305030785)

摘　　要：目的探讨血液净化治疗对感染性休克患者炎性损伤指标和氧代谢指标的临床影响效果,为感染性休克的临床诊治工作提供参考依据。方法选取2016年12月-2017年2月医院收治的感染性休克患者68例为研究对象,依据患者临床治疗方式不同将其分为研究组和对照组,各34例。对照组给予常规治疗,研究组在常规治疗的基础上给予血液净化治疗,对两组患者治疗前后的抗氧化指标、氧代谢指标、炎性损伤因子指标等进行检测、统计和比较。结果治疗后2、6、24h,研究组超氧化物歧化酶Orgotein(Superoxide Dismutase,SOD)、过氧化氢酶(Catalase,CAT)、谷胱甘肽过氧化物酶(Glutathione peroxidase,GSH-Px)均高于对照组(P<0.05),研究组治疗后24h各项酶性抗氧化指标分别为(83.45±8.41)nU/ml、(24.59±2.41)U/ml和(89.24±7.21)U/L);治疗后2、6、24h,维生素C(Vitamin C,VitC)、维生素E(Vitamin E,VitE)、一氧化氮(nitric oxide,NO)均高于对照组(P<0.05);治疗后2、6、24h,研究组中心静脉血氧饱和度(central venous blood oxygen saturation,ScvO2)高于对照组,脑氧摄取率(cerebral oxygen extraction rate,CEO2)及氧耗指数(oxygen consumption index,VO2I)均低于对照组(P<0.05);治疗后4d和7d,研究组肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-1(interleukin-1,IL-1)和白细胞介素-6(interleukin-6,IL-6)均低于对照组(P<0.05)。结论采用血液净化治疗感染性休克的临床效果较好,患者治疗后的炎性损伤及氧代谢指标改善程度较高,是临床治疗感染性休克的可靠选择之一。OBJECTIVE To explore the clinical effect of blood purification（BP）therapy on inflammatory injury indexes and oxygen metabolism indexes in patients with septic shock,so as to provide references for clinical diagnosis and treatment of septic shock.METHODS A total of 68 patients of septic shock for treatment in our hospital from Dec.2016 to Feb.2017 were chosen as the research subject.According to the different clinical treatment methods,they were divided into the study group and the control group,with 34 cases in each group.The control group was given the conventional treatment,and the study group was given the blood purification treatment.The indexes of antioxidant,oxygen metabolism,inflammatory injury factors and so on of the two groups were detected,and compaed before and after treatment.RESULTS The activities of superoxide dismutase（SOD）,catalase（CAT）and glutathione peroxidase（GSH-Px）of the study group were higher than those of the control group after2,6 and 24 hof treatment（P〈0.05）,and those indexes were（83.45±8.41）nU/ml,（24.59±2.41）U/ml and（89.24±7.21）U/L）in the study group after 24 hof treatment.The vitamin C（VitC）,vitamin E（VitE）and nitric oxide（NO）of the study group were higher than those of the control group after 2 h,6 h,and 24 hof treatment（P〈0.05）.After 2,6 and 24 hof treatment,the central venous blood oxygen saturation（ScvO2）of the study group was higher than that of the control group,the cerebral oxygen extraction rate（CEO2）and oxygen consumption index（VO2 I）of the study group were lower than those of the control group（P〈0.05）.The tumor necrosis factor-α（TNF-α）,interleukin^-1（IL^-1）and interleukin-6（IL-6）of the study group were lower than those of the control group after 4 dand 7 dof treatment（P〈0.05）.CONCLUSIONThe clinical effect of blood purification in the treatment of septic shock is significant,and the improvement of inflammatory injury and oxygen metabolism indexes of the patients after treatment is s

关 键 词：血液净化 感染性休克 炎性损伤 氧代谢 

分 类 号：R631.4[医药卫生—外科学]