早期连续性血液净化治疗老年重症脓毒血症急性肾损伤的临床效果  

Clinical Effects of Early Continuous Hemodialysis in the Treatment of Acute Kidney Injury in Elderly People with Severe Sepsis

作　　者：魏艳君[1] 李华[1] 孔秋生 Wei Yan-jun;Li Hua;Kong Qiu-sheng(Department of Critical Care,the First People's Hospital of Longquanyi District,Chengdu 610100,Sichuan Province,China)

机构地区：[1]成都市龙泉驿区第一人民医院重症科,四川成都610100

出　　处：《中外医药研究》2022年第12期48-50,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:分析在老年重症脓毒血症急性肾损伤(AKI)患者早期进行连续性血液净化(CBP)的治疗效果。方法:选取2019年4月-2021年4月成都市龙泉驿区第一人民医院收治的重症脓毒血症AKI的老年患者20例为观察对象,根据奇偶数分为对照组与观察组,各10例。对照组给予基础治疗,观察组在对照组基础上实施CBP治疗,比较两组患者肾功能[尿素氮(BUN)、肾小球滤过率(eGFR)、血清肌酐(Scr)]、炎性细胞因子[白细胞介素-6(IL-6)、C反应蛋白(CRP)、降钙素原(PCT)]、体征指标[舒张压(DBP)与舒张压(SBP)、血氧饱和度(SpO_(2))]及慢性健康状况评分[慢性健康评分表(APACHEⅡ)]。结果:治疗后,两组患者eGFR水平均升高,BUN、Scr水平均降低,观察组eGFR水平高于对照组,BUN、Scr水平低于对照组,差异有统计学意义(P<0.05);治疗后,两组患者IL-6、CRP、PCT水平均降低,观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组患者SBP、DBP、SpO_(2)水平均升高,观察组高于对照组,差异有统计学意义(P<0.05);观察组APACHEⅡ评分低于对照组,差异有统计学意义(P<0.05)。结论:老年重症脓毒血症AKI患者早期CBP治疗效果显著,可改善患者肾功能、体征指标及炎性因子水平,改善患者健康水平。Objective:To analyze the therapeutic effect of early continuous blood purification(CBP)in elderly patients with acute kidney injury(AKI)in severe sepsis.Methods:Twenty elderly patients with severe sepsis AKI admitted to the First People's Hospital of Longquanyi District,Chengdu,from April 2019 to April 2021 were selected for observation,and were divided into control group and observation group according to the odd and even numbers,10 cases each.The control group was given basic treatment,and the observation group was treated with CBP on the basis of the control group,and the renal function[urea nitrogen(BUN),glomerular filtration rate(eGFR),serum creatinine(Scr)],inflammatory cytokines[interleukin-6(IL-6),C-reactive protein(CRP),calcitoninogen(PCT)],physical indices[diastolic blood pressure(DBP)and diastolic blood pressure(SBP),blood oxygen saturation(SpO_(2))]and chronic health status score[Chronic Health Rating Scale(APACHEⅡ)].Results:After treatment,eGFR levels increased and BUN and Scr levels decreased in both groups.eGFR levels in the observation group were higher than those in the control group,and BUN and Scr levels were lower than those in the control group,with statistically significant differences(P<0.05);after treatment,IL-6,CRP and PCT levels decreased in both groups,with the observation group lower than those in the control group,with statistically significant differences(P<0.05).After treatment,SBP,DBP and SpO_(2) levels increased in both groups,and the observation group was higher than the control group,and the difference was statistically significant(P<0.05).The APACHEⅡ score of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion:Early CBP treatment in elderly patients with AKI with severe sepsis is effective and can improve renal function,signs index and inflammatory factor levels and improve patients'health.

关 键 词：脓毒血症 连续性血液净化 急性肾损伤 炎性细胞因子 

分 类 号：R73[医药卫生—肿瘤]