CRRT对输尿管结石梗阻并发尿脓毒症患者外周血免疫状态的影响  

Effects of CRRT on peripheral immune status in patients with ureteral calculi obstruction complicated with urosepsis

作　　者：张立颖 段刘剑[1] 张林[1] 曹建伟 钱苏波 黄云腾[1] Zhang Liying;Duan Liujian;Zhang Lin;Cao Jianwei;Qian Subo;Huang Yunteng(Department of Urology,Xinhua Hospital Affiliated to School of Medicine of Shanghai Jiao Tong University,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院泌尿外科,上海200092

出　　处：《国际泌尿系统杂志》2024年第1期78-82,共5页International Journal of Urology and Nephrology

摘　　要：目的探讨持续性肾脏替代疗法(CRRT)对输尿管结石梗阻并发尿脓毒症患者的治疗效果及外周血免疫状态的影响。方法回顾性分析2021年9月至2022年3月本院收治的24例输尿管结石梗阻并发尿脓毒症且治疗痊愈的患者的临床资料,其中6例接受CRRT治疗(CRRT组),18例仅接受标准治疗(对照组),比较两组患者的疗效及外周血炎症指标等的变化差异。结果尿脓毒症患者接受连续性肾脏替代治疗(CRRT)的治疗效果显著。CRRT组中的患者表现出较短的体温恢复时间[(4.5±1.8)d vs.(5.4±1.8)d],感染控制时间[(6.0±1.3)d vs.(7.3±2.2)d]以及肌酐恢复时间[(4.6±3.6)d vs.(5.7±2.4)d]。CRRT组患者治疗后的白细胞计数、C反应蛋白和炎症因子(IL-10、IL-6、IL-、TNF-α)水平均较治疗前显著下降,且下降速度快于对照组。结论CRRT能快速、有效地清除输尿管结石梗阻并发尿脓毒症患者体内的炎症因子,调节外周血免疫状态,从而缩短患者病程,改善患者预后。Objective To investigate the therapeutic effects of continuous renal replacement therapy(CRRT)in patients with ureteral calculi obstruction complicated with urosepsis and the influences on the peripheral immune status.Methods A retrospective analysis was performed on 24 patients with ureteral calculi obstruction complicated with urosepsis who got fully recovery in our hospital from September 2021 to March 2022,including 6 patients who received CRRT treatment(CRRT group)and the remaining 18 patients received only standard treatment(control group).The therapeutic effects and the dynamic variation patterns of some serum pro-inflammatory cytokines and anti-inflammatory cytokines were compared between two groups.Results The treatment outcomes of patients with pyelonephritis undergoing CRRT are significant.Patients in the CRRT group exhibited shorter body temperature recovery time[(4.5±1.8)d vs.(5.4±1.8)d],infection control time[(6.0±1.3)d vs.(7.3±2.2)d],and creatinine recovery time[(4.6±3.6)d vs.(5.7±2.4)d]compared to the control group.Furthermore,patients in the CRRT group experienced a significant decrease in white blood cell count,Creactive protein,and inflammatory cytokines(IL-10,IL-6,IL-8,TNF-α)levels post-treatment,with a significantly faster decline compared with the control group.Conclusions CRRT can rapidly and effectively remove inflammatory factors in patients with ureteral calculi obstruction complicated with urosepsis,regulate peripheral immune status,thereby shortening the course of disease and improving the prognosis of patients.

关 键 词：输尿管结石 尿源性脓毒症 连续性肾脏替代治疗 炎症因子 

分 类 号：R693.4[医药卫生—泌尿科学] R459.7[医药卫生—外科学]