连续性血浆吸附联合血液滤过治疗脓毒症急性肾损伤的临床观察  

Clinical observation of septic acute kidney injury treated by continuous plasma adsorption combined with hemofiltration

作　　者：伍尚伟 梁世杰 黄欢[1] WU Shang-wei;LIANG Shi-jie;HUANG Huan(Department of Internal Medicine,Guangning County People's Hospital,Zhaoqing 526300,China)

机构地区：[1]广宁县人民医院内科,526300

出　　处：《中国现代药物应用》2023年第11期44-47,共4页Chinese Journal of Modern Drug Application

基　　金：广东省肇庆市科技计划项目(项目编号:2021040307007)。

摘　　要：目的 探究连续性血浆吸附联合血液滤过治疗脓毒症急性肾损伤(AKI)的临床疗效及对炎症因子的影响。方法 72例脓毒症AKI患者,采用随机数字表法分为研究组和对照组,各36例。对照组采用连续性静脉-静脉血液滤过(CVVH)治疗,研究组在对照组基础上给予连续性血浆吸附治疗。比较两组治疗前后炎症因子[超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)]水平、急性生理学与慢性健康状况评价系统Ⅱ(APACHEⅡ)评分、肾功能指标[血尿素氮(BUN)、血清肌酐(SCr)]、氧合指数及28 d存活率。结果 治疗后,两组hs-CRP、IL-6水平及APACHEⅡ评分均显著低于本组治疗前,且研究组hs-CRP(31.06±9.58)mg/L、IL-6(56.36±43.98)ng/ml、APACHEⅡ评分(10.48±3.41)分低于对照组的(54.08±12.52)mg/L、(97.75±68.17)ng/ml、(13.56±3.95)分,差异均有统计学意义(P<0.05)。治疗后,两组BUN、SCr水平均显著低于本组治疗前,氧合指数显著高于本组治疗前,且研究组SCr(63.14±15.62)μmol/L、BUN(7.89±3.17)mmol/L均低于对照组的(84.51±17.35)μmol/L、(13.51±4.02)mmol/L,氧合指数(358.63±111.92)mm Hg(1 mm Hg=0.133 kPa)高于对照组的(290.76±102.02)mm Hg,差异均有统计学意义(P<0.05)。研究组患者28 d存活率为80.56%,明显高于对照组的58.33%,差异有统计学意义(P<0.05)。结论 连续性血浆吸附联合血液滤过治疗脓毒症AKI患者,可进一步降低炎症因子水平并改善预后。Objective To investigate the clinical efficacy of continuous plasma adsorption combined with hemofiltration in the treatment of septic acute kidney injury(AKI),and its influence on inflammatory factors.Methods A total of 72 patients with septic AKI were divided into research group and control group according to the random numerical table,with 36 cases in each group.The control group was treated with continuous veno-venous hemofiltration(CVVH),and the research group was treated with continuous plasma adsorption based on the control group.Both groups were compared in terms of levels of inflammatory factors[high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)],Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)score,renal function index[blood urea nitrogen(BUN),serum creatinine(SCr)]and oxygenation index before and after treatment,and 28-day survival rate.Results After treatment,the levels of hs-CRP,IL-6 and APACHEⅡscore in the two groups were significantly lower than those before treatment in this group;the research group had hs-CRP of(31.06±9.58)mg/L,IL-6 of(56.36±43.98)ng/ml and APACHEⅡscore of(10.48±3.41)points,which were lower than those of(54.08±12.52)mg/L,(97.75±68.17)ng/ml and(13.56±3.95)points in the control group;the differences were statistically significant(P<0.05).After treatment,the levels of BUN and SCr in the two groups were significantly lower than those before treatment in this group,and the oxygenation index was significantly higher than before treatment in this group;SCr of(63.14±15.62)μmol/L and BUN of(7.89±3.17)mmol/L in the research group were lower than those of(84.51±17.35)μmol/L and(13.51±4.02)mmol/L in the control group;oxygenation index of(358.63±111.92)mm Hg(1 mm Hg=0.133 kPa)in the research group was higher than that of(290.76±102.02)mm Hg in the control group;the differences were statistically significant(P<0.05).The 28-d survival rate of the research group was 80.56%,which was significantly higher than that of 58.33%of the control group,and the di

关 键 词：连续性血浆吸附 血液滤过 脓毒症 急性肾损伤 

分 类 号：R459.7[医药卫生—急诊医学] R692[医药卫生—治疗学]