早期连续性血液净化治疗热射病的疗效观察  

Observation of curative effect of early continuous blood purification on heat stroke

作　　者：张一凡 闫登峰[2] 马伯恩 Zhang Yifan;Yan Dengfeng;Ma Boen(Department of Respiratory Intensive Care Unit,Zhoukou Central Hospital,Zhoukou 466000,China;Department of Emergency Intensive Care Medicine,Zhoukou Central Hospital,Zhoukou 466000,China)

机构地区：[1]周口市中心医院RICU,周口466000 [2]周口市中心医院急诊重症医学科,周口466000

出　　处：《中国实用医刊》2023年第19期39-42,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨早期连续性血液净化治疗热射病的效果。方法抽取2020年4月至2023年4月周口市中心医院接收的90例热射病患者,按照随机数字表法分为对照组与观察组,每组45例。对照组予以常规治疗,观察组在常规治疗基础上予以早期连续性血液净化治疗。比较两组治疗前后炎症因子水平[白细胞介素-17(IL-17)、肿瘤坏死因子-ɑ(TNF-ɑ)、C反应蛋白(CRP)]、凝血功能指标[D-二聚体(D-D)]、心功能指标[心肌肌钙蛋白I(cTnI)]、肾功能指标[β2-微球蛋白(β2-MG)]。比较两组预后情况[急性生理功能和慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、改良序贯器官衰竭评分(SOFA)]。结果治疗前,两组IL-17、TNF-ɑ、CRP水平比较差异未见统计学意义(P>0.05);治疗后,两组IL-17、TNF-ɑ、CRP水平均低于治疗前,且观察组低于对照组(P<0.05)。治疗前,两组D-D、cTnI、β2-MG水平比较差异未见统计学意义(P>0.05);治疗后,两组D-D、cTnI、β2-MG水平均降低,且观察组低于对照组(P<0.05)。治疗后,两组APACHEⅡ评分、SOFA均低于治疗前,且观察组低于对照组(P<0.05)。结论早期连续性血液净化治疗热射病可有效降低患者的炎症因子水平,并改善D-D、cTnI、β2-MG水平,进一步改善患者预后。Objective To investigate the curative effect of early continuous blood purification in the treatment of heat stroke.Methods A total of 90 patients with heat stroke treated in Zhoukou Central Hospital from April 2020 to April 2023 were selected,and they were divided into control group and observation group by random number table method,with 45 cases in each group.The control group was treated by routine treatment,and the observation group were treated by early continuous blood purification treatment on the basis of routine treatment.The levels of inflammatory factors,including interleukin-17(IL-17),tumor necrosis factor-ɑ(TNF-ɑ)and C-reactive protein(CRP),coagulation indexe D-dimer(D-D),cardiac function index cardiac troponin I(cTnI)and renal function indexβ2-microglobulin(β2-MG)were compared between the two groups before and after treatment.The prognosis assessed by acute physiology and chronic health evaluationⅡ(APACHEⅡ)score and sequential organ failure score(SOFA)were compared between the two groups.Results Before treatment,there was no significant difference in levels of IL-17,TNF-ɑand CRP between the two groups(P>0.05).After treatment,the levels of IL-17,TNF-ɑand CRP of the two groups were lower than those before treatment,and the observation group had lower levels of these indexes than the control group(P<0.05).Before treatment,there was no significant difference in levels of D-D,cTnI andβ2-MG between the two groups(P>0.05).After treatment,the levels of D-D,cTnI andβ2-MG of the two groups decreased,and the levels of D-D,cTnI andβ2-MG in the observation group were lower than those in the control group(P<0.05).After treatment,the APACHEⅡscore and SOFA of the two groups were lower than those before treatment,and the observation group had lower APACHEⅡscore and SOFA than the control group(P<0.05).Conclusions Early continuous blood purification can effectively reduce the level of inflammatory factors,improve the levels of D-D,cTnI andβ2-MG,moreover,it can further improve the prognosis of patien

关 键 词：热射病 连续性血液净化 预后 

分 类 号：R594.1[医药卫生—内科学]