不同血液滤过方式联合血液灌流对蜂蛰伤合并多器官功能障碍综合征患者心肌酶谱、抗氧化能力及肾功能的影响  

Effects of hemoperfusion combined with different hemofiltration on myocardial enzyme spectrum,antioxidant capacity and renal function in patients with bee stings and multiple organ dysfunction syndrome

作　　者：张宾[1] 代洪娜[2] 胡莹莹[1] Zhang Bin;Dai Hongna;Hu Yingying(Department of Emergency,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)

机构地区：[1]河南科技大学第一附属医院急诊科,洛阳471000 [2]河南科技大学第一附属医院血管外科,洛阳471000

出　　处：《国际移植与血液净化杂志》2022年第2期31-34,共4页International Journal of Transplantation and Hemopurification

摘　　要：目的探究蜂蛰伤合并多器官功能障碍综合征(muliple organ dysfunction syndrome,MODS)惠者行不同方式血液滤过联合血液灌流治疗的效果及其对肾功能、抗氧化能力及心肌酶谱的影响。方法采用数字表法将我院2017年8月至2020年8月间蜂蛰伤合并MODS患者103例随机分为两组,观察组52例行连续性静脉静脉血液滤过(CVVH)联合血液灌流,对照组51例行间歌性血液透析联合血液灌流,两组患者均连续治疗3次。对比治疗前、后疗效、患者肾功能、抗氧化能力及心肌酶谱变化。结果治疗后,观察组乳酸脱氢酶、肌酸激酶同工酶、丙二醛、血清胱抑素C、血尿素氮、血肌酐和肌酸激酶水平均较对照组低,谷胱甘肽过氧化物酶、超氧化物歧化酶较对照组高,差异具有统计学意义(P<0.05)。两组患者并发症发生情况差异无统计学意义(P>0.05)。结论CVVH联合血液濯流可显著改善蜂蛰伤合并MODS患者心肌酶水平和机体抗氧化能力,改善肾功能,且安全有效。Objective To explore the effects of different hemofiltration plus hemoperfusion in patients with bee sting combined with multiple organ dysfunction syndrome(MODS)and their effects on renal function,antioxidant capacity and myocardial enzyme spectrum.Methods A total of 103 patients with bee sting injury and MODS in our hospital were divided into two groups by random number table from August 2017 to August 2020.Fifty-two cases of the observation group underwent continuous venous-venous hemofiltration(CVVH)combined with hemoperfusion.In the control group,51 patients underwent intermittent hemodialysis combined with hemoperfusion.All the patients were treated for three consecutive times.Renal function,anti-oxidation and myocardial enzyme spectrum of the two groups were compared.Results At the end of the treatment,the levels of lactate dehydrogenase(LDH),creatine kinase MB isoenzyme(CK-MB),malonaldehyde(MDA),serum cystotin C(Cys-C),blood urine nitrogen(BUN),serum creatinine(Scr)and creatine kinase(CK)in the observation group were lower than those in the control group.Glutathione peroxidase(GSH-Px)and superoxide dismutase(SOD)in the observation group were higher than those in the control group.Conclusion CVVH combined with hemoperfusion can significantly improve the levels of myocardial enzymes,antioxidant capacity and renal function.It is safe and effective.

关 键 词：多器官功能障碍综合征 蜂蛰伤 连续性静脉-静脉血液滤过 血液灌流 

分 类 号：R646[医药卫生—外科学]