重症急性胰腺炎患者CPFA治疗对炎性介质、肠黏膜屏障功能的影响  

EFFECTS OF CPFA ON INFLAMMATORY MEDIATORS AND INTESTINAL MUCOSAL BARRIER FUNCTION IN PATIENTS WITH SEVERE ACUTE PANCREATITIS

作　　者：周紫微 梅丽军 ZHOU Ziwei;MEI Lijun(Chengdu Third People's Hospital,Chengdu 610031,China)

机构地区：[1]四川省成都市第三人民医院,610031

出　　处：《中国煤炭工业医学杂志》2023年第1期81-86,共6页Chinese Journal of Coal Industry Medicine

基　　金：2020年四川省医学科研课题项目(编号:S20006)。

摘　　要：目的 探讨重症急性胰腺炎(SAP)患者采用连续血液滤过吸附(CPFA)治疗的临床效果。方法 选取该院急诊科既往治疗的78例SAP患者进行回顾性分析,根据患者接受的治疗方案进行分组,其中40例患者采用常规治疗+CPFA治疗(研究组)、另外38例患者采用常规治疗+高容量血液滤过(HVHF)作为对照组;对比两组患者治疗前、治疗1周后血清肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、可溶性髓样细胞触发受体-1(sTREM-1)、可溶性CD14亚型(Presepsin)、血浆二胺氧化酶(DAO)、D-乳酸、急性生理功能与慢性健康评分(APACHEⅡ)、血淀粉酶、尿淀粉酶、外周血白细胞(WBC)、28 d患者生存率。结果 治疗前,研究组和对照组的血清TNF-α、IL-1β、IL-6、IL-10、sTREM-1、Presepsin水平差异无统计学意义(P>0.05);治疗1周后,研究组的血清TNF-α、IL-1β、IL-6、sTREM-1、Presepsin水平均低于对照组(P<0.05),研究组的IL-10水平高于对照组(P<0.05);治疗前,研究组和对照组的DAO、D-乳酸差异无统计学意义(P>0.05);治疗1周后,研究组的DAO、D-乳酸均低于对照组(P<0.05);治疗前,研究组和对照组的APACHEⅡ评分、血淀粉酶、尿淀粉酶、外周血WBC水平差异无统计学意义(P>0.05);治疗1周后,研究组的APACHEⅡ评分、血淀粉酶、尿淀粉酶均低于对照组(P<0.05);治疗28d后,研究组的生存率92.50%与对照组的86.84%比较,差异均无统计学意义(P>0.05)。结论 CPFA治疗SAP患者较HVHF更有利于减轻炎症反应、保护胃黏膜屏障,对于改善患者病情效果更显著。Objective To investigate the clinical effect of continuous hemofiltration adsorption(CPFA) treatment in patients with severe acute pancreatitis(SAP). Methods A total of seventy-eight SAP patients with previous treatment in the emergency department of our hospital were selected for retrospective analysis.According to the treatment plan received by the patients, 40 patients were treated with conventional treatment and CPFA(study group),and the other 38 patients were treated with conventional treatment and high volume hemofiltration(HVHF) as the control group.The serum levels of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-6(IL-6),interleukin-10(IL-10),soluble triggering receptor of myeloid cell 1(sTREM-1) and soluble CD14 subtype(Presepsi) were compared between the two groups before treatment and one week after treatment n),plasma diamine oxidase(DAO),D-lactate, acute physiological function and chronic health score(APACHEⅡ),blood amylase, urine amylase, peripheral blood white blood cell(WBC),28d survival rate. Results Before treatment, there was no significant difference in serum TNF-α,IL-1β,IL-6,IL-10,sTREM-1,and Presepsin levels between the study group and the control group(P>0.05).After 1 week of treatment, the study group Serum levels of TNF-α,IL-1β,IL-6,sTREM-1,and Presepsin were lower than those in the control group(P<0.05),and IL-10 levels in the study group were higher than those in the control group(P<0.05);before treatment There was no significant difference in DAO and D-lactic acid between the study group and the control group(P>0.05).After 1 week of treatment, the DAO and D-lactic acidin the study group were lower than those in the control group(P<0.05).Before treatment, There was no significant difference in APACHEⅡ score, blood amylase, urine amylase, and peripheral blood WBC levels between the study group and the control group(P>0.05).After 1 week of treatment, the APACHEⅡ score, blood amylase, and urine amylase of the study group All were lower than the control grou

关 键 词：重症急性胰腺炎 连续血液滤过吸附 炎性介质 肠黏膜 

分 类 号：R392[医药卫生—免疫学]