床边持续血液滤过对重症急性胰腺炎患者生存质量及白介素-6水平的影响  

Effects of continuous renal replacement therapy on quality of life and interleukin-6 level on patients with severe acute pancreatitis

作　　者：陈明科[1] 朱永[1] 谢晓红[1] 李娜[1] CHEN Mingke;ZHU Yong;XIE Xiaohong;LI Na(Intensive Care Unit,Hainan General Hospital,Hainan Affiliated Hospital of Hainan Medical University,Hainan,Haikou 570311,China)

机构地区：[1]海南省人民医院海南医学院附属海南医院重症医学科,海南海口570311

出　　处：《中国医药科学》2022年第15期42-45,81,共5页China Medicine And Pharmacy

基　　金：海南省医药卫生科研项目(20A200132)。

摘　　要：目的探讨床边持续血液滤过(CRRT)对重症急性胰腺炎(SAP)患者生存质量及白介素-6(IL-6)水平的影响。方法选取2013年8月至2022年1月于海南省人民医院住院的SAP患者120例,按随机数字表法分为对照组和治疗组。对照组60例,采用常规西医治疗方法;治疗组60例,在常规西医治疗基础上应用CRRT治疗。观察两组患者治疗后的生存质量、生存率、症状及体征恢复时间及治疗前后免疫功能、IL-6水平变化情况。结果治疗后对照组生活质量提高12例,稳定25例,下降23例;治疗组患者生活质量提高42例,稳定13例,下降5例,两组比较差异有统计学意义(P<0.05)。治疗后,治疗组患者自然杀伤细胞(NK)及CD4+/CD8+升高,而对照组NK降低,且治疗组NK,CD4+/CD8+均高于对照组,差异有统计学意义(P<0.05)。两组患者治疗前血清IL-6水平比较,差异无统计学意义(P>0.05);治疗组患者治疗后1、2、3、7 d血清IL-6水平低于对照组,且较治疗前下降明显(P<0.05)。与对照组比较,治疗组腹痛症状缓解时间、体温及肠道功能恢复正常时间、住院时间更短(P<0.05)。治疗组患者生存率显著高于对照组,差异有统计学意义(P<0.05)。结论CRRT治疗能改善SAP患者的生存质量及预后,可能通过提高CD4+/CD8+,改善NK细胞的活性,抑制血清IL-6水平发挥作用。Objective To investigate the effects of continuous renal replacement therapy(CRRT)on quality of life(QoL)and interleukin-6(IL-6)level on patients with severe acute pancreatitis(SAP).Methods A total of 120 patients with SAP hospitalized in Hainan General Hospital from August 2013 to January 2022 were selected.They were divided into the control group(n=60)and the treatment group(n=60)according to the random number table method.The control group was treated with conventional western medicine,while the treatment group was treated with CRRT based on conventional western medicine.The QoL,survival rate,recovery time of symptoms and signs,and changes of immune function and IL-6 level of patients before and after treatment were observed.Results After treatment,in the control group,the QoL of patients in 12 cases increased,25 cases stabilized,and 23 cases decreased.In the treatment group,the QoL of patients in 42 cases increased,13 cases stabilized,and 5 cases decreased.The contrast differences between the two groups were statistically significant(P<0.05).After treatment,NK and CD4+/CD8+of patients in the treatment group was increased,but NK decreased in the control group,and NK,CD4+/CD8+in the treatment group were higher than those in the control group,with statistically significant differences(P<0.05).Before treatment,there was no statistically significant difference in serum IL-6 levels of patients between the two groups(P>0.05).The levels of serum IL-6 in patients of the treatment group were lower than those of the control group on the 1st,2nd,3rd and 7th day after treatment,and they were significantly lower than those before treatment(P<0.05).Compared with the control group,the relief time of abdominal pain symptoms,the recovery time of body temperature and intestinal function in the treatment group were shorter,and the hospitalization time of patients was shorter,all with statistically significant differences(P<0.05).The survival rate of patients in the treatment group was higher than that in the control group,with s

关 键 词：重症急性胰腺炎 床边持续血液滤过 生存质量 白细胞介素-6 

分 类 号：R576[医药卫生—消化系统]