oXiris-内毒素吸附技术治疗ESRD合并脓毒症患者的临床效果观察  

Clinical observation of oXiris-endotoxin adsorption technique in the treatment of ESRD patients with sepsis

作　　者：黄河奔 吕君睿 郭琼琼 李雯甜 孙钰欣 王俊霞[1] HUANG He-ben;LYU Jun-rui;GUO Qiong-qiong;LI Wen-tian;SUN Yu-xin;WANG Jun-xia(Critical Care Nephrology Unit,the First Affiliated Hospital of Henan University of Science and Technology,luoyang 471000,China)

机构地区：[1]河南科技大学第一附属医院危重肾脏监护病房,洛阳471000

出　　处：《中国血液净化》2024年第4期250-255,共6页Chinese Journal of Blood Purification

基　　金：河南省联合共建项目(LHGJ20234080)。

摘　　要：目的探讨oXiris-内毒素吸附技术治疗终末期肾病(end-stage renal disease,ESRD)合并脓毒症的疗效。方法回顾性收集2020年1月1日—2023年7月30日于河南科技大学第一附属医院住院治疗的ESRD合并脓毒症患者41例,其中oXiris组22例,连续性静脉-静脉血液滤过(continuous veno-venous hemofiltration,CVVH)联合血液灌流(hemoperfusion,HP)组19例。比较2组患者住院死亡率、ICU住院时长、机械通气时长、连续性肾脏替代治疗时长、机械通气患者数、使用滤器数以及在血液净化治疗开始时及治疗后急性生理与慢性健康评分(acute physiology and chronic health evaluation,APACHE-Ⅱ)、去甲肾上腺素(norepinephrine,NE)用量以及实验室检查结果。结果oXiris组患者机械通气时长少于CVVH+HP组(Z=-3.749,P=0.001)。治疗后oXiris组APACHE-Ⅱ评分(t=-4.481,P=0.001)、NE用量(t=-2.036,P=0.049)、C反应蛋白(Z=-2.850,P=0.004)、白细胞介素-6(Z=-2.512,P=0.012)水平较CVVH+HP组降低。结论oXiris-内毒素吸附技术能有效降低ESRD合并脓毒症患者炎症介质,且效果优于CVVH+HP,具有良好的临床应用价值。Objective To investigate the efficacy of oXiris-endotoxin adsorption technique in the treatment of end-stage renal disease(ESRD)complicated with sepsis.Methods A total of 41 patients with ESRD complicated with sepsis who were hospitalized in the First Affiliated Hospital of Henan University of Science and Technology from January 1,2021 to July 30,2023 were enrolled.Among these patients,22 are in the oXiris filter treatment group,and the other 19 patietns are in the group treated by continuous veno-venous hemofiltration(CVVH)combined with Hemoperfusion(HP).In-hospital mortality,length of stay in ICU,length of mechanical ventilation,length of continuous renal replacement therapy,number of patients with mechanical ventilation,number of filter and Acute Physiology and Chronic Health Evaluation(Apache-Ⅱ),Norepinephrine(NE)dosage and laboratory test results at the beginning of and after hemopurification treatment were compared between the two groups.Results The mechanical ventilation duration in oXiris group was significantly shorter than that in CVVH+HP group(Z=-3.749,P=0.001).After treatment,APACHE-Ⅱ(t=-4.481,P=0.001),NE dosage(t=-2.036,P=0.049),C-reactive protein,procalcitonin(Z=-2.850,P=0.004),interleukin-6(Z=-2.512,P=0.012)in oXiris group were significantly lower than those in CVVH+HP group.Conclusion oXiris-endotoxin adsorption technique can effectively reduce inflammatory factors in ESRD patients with sepsis,and it’s effect is better than CVVH+HP treatment;which has good value of clinical application.

关 键 词：oXiris-内毒素吸附技术 血液灌流 脓毒症 终末期肾病 

分 类 号：R459.5[医药卫生—治疗学]