连续性肾替代疗法对严重脓毒症患者血清IL-6、PCT、hs-CRP和SAA水平的影响  

Effect of Continuous Renal Replacement Therapy on Serum IL-6,PCT,hs-CRP and SAA Levels in Patients with Severe Sepsis

作　　者：崔巍[1] 赵丰莹[1] 虎琼华[1] CUI Wei;ZHAO FengTing;HU Qionghua(Depamnent of Severe Medicine,Second People＇s Hospital of Chengdu, Chengdu 610017, China)

机构地区：[1]成都市第二人民医院重症医学科,成都610017

出　　处：《解放军预防医学杂志》2018年第9期1148-1150,共3页Journal of Preventive Medicine of Chinese People's Liberation Army

基　　金：四川省卫生和计划生育委员会科研课题(No.150010)

摘　　要：目的分析连续性肾替代疗法(CRRT)对严重脓毒症患者血清白介素-6(IL-6)、降钙素原(PCT)、超敏C反应蛋白(hs-CRP)及血清样淀粉酶A(SAA)水平的影响。方法采用随机抽签法将80例严重脓毒症患者分为病例组与对照组,各40例。对照组接受常规干预,病例组除常规干预外,还行CRRT治疗,两组均连续干预1周。测定治疗前后急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)、多器官功能障碍综合征(MODS)评分、血清IL-6、PCT、hs-CRP及SAA水平,统计28 d病死率。结果与治疗前比较,两组治疗1周APACHEⅡ、MODS评分、血清IL-6、PCT、hs-CRP及SAA水平均显著下降,差异有统计学意义(P<0.05);病例组治疗1周APACHEⅡ、MODS评分、血清IL-6、PCT、hs-CRP及SAA水平均显著低于对照组(P<0.05);病例组28 d病死率为5.00%,显著低于对照组的22.50%,差异有统计学意义(P<0.05)。结论 CRRT能明显降低严重脓毒症患者血清IL-6、PCT、hs-CRP与SAA水平,能有效清除炎症因子,降低28 d病死率,改善患者预后。Objective To analyze the effect of continuous renal replacement therapy（ CRRT） on serum interleukin-6（ IL-6）,procalcitonin（ PCT）,high-sensitivity C-reactive protein（ hs-CRP） and serum amylase A（ SAA） levels in patients with severe sepsis.Methods Eighty patients with severe sepsis were randomly divided into the case group and the control group,with 40 cases in each. The control group was given routine interventions while the case group was additionally given CRRT that lasted one week. The scores of Acute Physiology and Chronic Health Evaluation II（ APACHE II） and multiple organ dysfunction syndrome（ MODS） as well as serum IL-6,PCT,hs-CRP and SAA levels were determined before and after treatment. The 28-day mortality rate was statistically analyzed. Results Scores of APACHEⅡ and MODS,serum IL-6,PCT,hs-CRP and SAA levels in both groups were significantly decreased after one week of treatment（ P〈0.05）,especially in the case group（ P〈0.05）.The 28-day mortality rate of the case group was significantly lower than that of the control group（ 5.00% vs 22.50%）（ P〈0.05）.Conclusion CRRT can significantly reduce the levels of serum IL-6,PCT,hs-CRP and SAA in patients with severe sepsis,effectively eliminate inflammatory factors,reduce the 28-day mortality rate and improve the prognosis of patients.

关 键 词：连续性肾替代疗法 严重脓毒症 炎症因子 

分 类 号：R459.7[医药卫生—急诊医学]