多巴酚丁胺联合高容量血液滤过治疗感染性休克的效果及对患者血清IL-1β、TSP-1水平的影响  

Efficacy of Dobutamine Combined with High Volume Hemofiltration on the Septic Shock and Its Effect on the Serum IL-1β,TSP-1 Levels

作　　者：谢振林[1] 冯雅建 范志伟[1] 杨宏飞 张东星 XIE Zhen-lin;FENG Ya-jian;FAN Zhi-wei;YANG Hong-fei;ZHANG Dong-xing(Emergency internal medicine,Southeast University Affiliated Zhongda Hospital,Nanjing,Jiangsu,210009,China)

机构地区：[1]东南大学附属中大医院急诊内科,江苏南京210009

出　　处：《现代生物医学进展》2021年第9期1664-1668,共5页Progress in Modern Biomedicine

基　　金：江苏省自然科学基金项目(BK20150645)。

摘　　要：目的:探究多巴酚丁胺联合高容量血液滤过治疗感染性休克的临床效果及对患者血清白细胞介素-1β(IL-1β)、血小板反应蛋白1(TSP-1)水平的影响.方法:选取2018年10月-2019年10月于我院接受治疗的感染性休克患者100例,将其随机分为血液滤过组、联合治疗组,每组各50例.血液滤过组患者进行高容量血液滤过治疗,联合治疗组患者使用多巴酚丁胺联合高容量血液滤治疗.采用免疫透射比浊法检测血肌酐(Scr)、血尿素氮(BUN)、胱抑素C(Cys-C)水平;监护仪及流式细胞术检测血流动力学、T淋巴细胞亚群水平;酶联免疫吸附实验法检测血清谷胱甘肽过氧化物酶(GSH-Px)、过氧化脂(LPO)、丙二醛(MDA)、IL-1β、TSP-1水平,并比较两组患者的治疗有效率.结果:治疗后,联合治疗组患者血清BUN、Scr、Cys-C、LPO、MDA、IL-1β、TSP-1水平、HR均显著低于血液滤过组(P<0.05),CI、MAP、血清GSH-Px水平均高于血液滤过组(P<0.05),CD8^(+)水平显著低于血液滤过组,而CD4^(+)、CD3^(+)水平高于血液滤过组(P<0.05).联合治疗组患者治疗总有效率为94%,显著高于血液滤过组(80%,P<0.05).结论:多巴酚丁胺联合高容量血液滤过治疗感染性休克的疗效显著优于单用高容量血液滤过治疗,其能够显著改善患者肾功能及血流动力学,减轻氧化应激,提升患者免疫功能,降低血清IL-1β、TSP-1水平.Objective: To investigate the clinical effect of dobutamine combined with high volume hemofiltration in the treatment of septic shock and its effect on serum levels of interleukin-1 beta(IL-1 beta) and thrombospondin-1(TSP-1). Methods: A total of 100 patients with septic shock who were treated in our hospital from October 2018 to October 2019 were selected and randomly divided into hemofiltration group and combined treatment group, with 50 patients in each group.Patients in the hemofiltration group were treated with high-volume hemofiltration, and patients in the combined treatment group were treated with dobutamine combined with high-volume hemofiltration.Serum creatinine(Scr), blood urea nitrogen(BUN), cystatin C(Cys-C) levels were detected by immunoturbidimetry;hemodynamics and T lymphocyte subset levels were detected by monitor and flow cytometry;serum glutathione peroxidase(GSH-Px),lipid peroxide(LPO), malondialdehyde(MDA), IL-1 beta, TSP-1 levels were detected by enzyme-linked immunosorbent assay, and the therapeutic effectiveness of the two groups of patients was compared Rate. Results: After treatment, the levels of serum BUN, Scr, Cys-C,LPO, MDA, IL-1 beta, TSP-1 and HR in the combined treatment group were significantly lower than those in the hemofiltration group(P<0.05), the levels of CI, MAP and serum GSH-Px were higher than those in the hemofiltration group(P<0.05), and the levels of CD8+were significantly lower than those in the hemofiltration group, while the levels of CD4+, CD3+were higher than those in the hemofiltration group(P<0.05). The total effective rate of the combined treatment group was 94%, which was significantly higher than that of the hemofiltration group(80%, P<0.05). Conclusion: The efficacy of dobutamine combined with high volume hemofiltration in the treatment of septic shock is significantly better than that of high volume hemofiltration alone, which can significantly improve renal function and hemodynamics, reduce oxidative stress, improve immune function, and reduce serum leve

关 键 词：多巴酚丁胺 高容量血液滤过 感染性休克 血流动力学 

分 类 号：R631.4[医药卫生—外科学] R459.5[医药卫生—临床医学]