连续肾脏替代疗法对重症急性胰腺炎患者肠黏膜功能、炎性介质以及氧化应激指标的影响  

Effects of Continuous Renal Replacement Rherapy on Intestinal Mucosal Function,Fnflammatory Fediators and Fxidative Ftress in Fatients with Fevere Acute Pancreatitis

作　　者：魏义 任红旗 王斌[1] 张斌 张琛 焦娇 张君利 WEI Yi;REN Hong-qi;WANG Bin;ZHANG Bin;ZHANG Chen;JIAO Jiao;ZHANG Jun-li(Department of Intensive Medicine,Xuzhou Cancer Hospital/Xuzhou Third People's Hospital,Xnzhou 221000,China;Department of Nephrology,Huaihai Hospital Affiliated to Xuzhou Medical University/People’s Liberation Army No.71 Military Hospital,Xuzhou 221004,China;Department of Gastroenterology,Huaihai Hospital Affiliated to Xiizhou Medical University/People's Liberation Army No.71 Military Hospital^Xuzhou 221004,China;Department of Intensive Medicine,Huaihai Hospital Affiliated to Xuzhou Medical University/People's Liberation Army No.71 Military Hospital,Xuzhou 221004,China)

机构地区：[1]徐州市肿瘤医院/徐州市第三人民医院重症医学科,江苏徐州221000 [2]徐州医科大学附属淮海医院/中国人民解放军陆军第七十一集团军医院肾内科,江苏徐州221000 [3]徐州医科大学附属淮海医院/中国人民解放军陆军第七十一集团军医院消化科,江苏徐州221000 [4]徐州医科大学附属淮海医院/中国人民解放军陆军第七十一集团军医院重症医学科,江苏徐州221000

出　　处：《药物生物技术》2020年第6期523-526,共4页Pharmaceutical Biotechnology

基　　金：江苏省基础研究计划(自然科学基金)(No.BK20181150)。

摘　　要：讨论连续肾脏替代疗法(CRRT)对重症急性胰腺炎(SAP)患者肠黏膜功能、炎性介质以及氧化应激指标的影响。选择2017年1月~2019年4月徐州市肿瘤医院及徐州医科大学附属淮海医院收治SAP患者126例,按照治疗方式将患者分成两组,每组63例;对照组患者采用常规治疗,观察组在常规治疗基础上加用CRRT治疗;对比两组患者治疗后炎症因子水平、肠黏膜功能、氧化应激指标以及血乳酸、血淀粉酶(AMS)水平。治疗后,观察组患者IL-1β、s ICAM-1、PCT、ET、DAO、D-lactose、MDA、AOPPs以及血乳酸、AMS水平均较治疗前降低(P<0.05),且观察组上述指标均低于对照组(P<0.05);APN、SOD、GSH-Px水平较治疗前升高(P<0.05),且均高于对照组(P<0.05)。CRRT治疗能更有效减少SAP患者血液中炎症介质含量,调控患者氧化/抗氧化平衡,保护肠黏膜功能,有一定的临床应用价值。To discuss the effects of continuous renal replacement therapy(CRRT) on intestinal mucosal function,inflammatory mediators and oxidative stress in patients with severe acute pancreatitis(SAP),126 patients with SAP were selected from January2017 to April 2019 in Xuzhou Cancer Hospital and Huaihai Hospital Affiliated to Xuzhou Medical University.Based on the treatment method,the patients were divided into two groups,63 cases in each group.The patients in the control group were treated with routine therapy,while the patients in the observation group were treated with CRRT on the basis of routine treatment.The time of each treatment was 12 hours to 24 hours,once a day.Based on the patient’s condition,repeat treatment 3 ~ 5 times.Medical staff should also pay close attention to vital signs such as heart rate and blood pressure.3 m L of elbow vein blood was collected at admission and after treatment.The levels of inflammatory factors,intestinal mucosal function,oxidative stress,blood lactate and amylase(AMS) were compared between the two groups after treatment.The results showed that before the treatment,there were no significant differences in the levels of IL-1 β,s ICAM-1,PCT,et,Dao,D-lactose,MDA,AOPPs,blood lactate and AMS between the two groups(P>0.05).The levels of IL-1β,s ICAM-1,PCT,ET,DAO,D-lactose,MDA,AOPPs,blood lactate and AMS in the observation group were lower than those before treatment(P<0.05),and the above indexes in the observation group were lower than those in the control group(P<0.05).The levels of APN,SOD and GSH-Px were higher than those before treatment(P<0.05),and higher than those in the control group(P<0.05).CRRT can reduce the content of inflammatory mediators in the blood of SAP patients,regulate the balance of oxidation and antioxidation,and protect intestinal mucosal function.It has high clinical application value.

关 键 词：连续肾脏替代疗法 重症急性胰腺炎 肠黏膜功能 炎症反应 氧化应激反应 血乳酸 血淀粉酶 

分 类 号：R459.5[医药卫生—治疗学]