CRRT联合HP治疗脓毒症患者对炎症介质及生化指标水平的影响  

Effect of CRRT combined with HP on inflammatory mediators and biochemical indexes in septic patients

作　　者：姜玉凤 林立建 林仁杰 徐先锋 郑澍云 JIANG Yufeng;LIN Lijian;LIN Renjie;XU Xianfeng;ZHENG Shuyun(Department of Critical Care Medicine,Fuzhou Changle District People’s Hospital,Fujian,Fuzhou 350200,China;Department of Cardiovascular Medicine,Fuzhou Changle District People’s Hospital,Fujian,Fuzhou 350200,China)

机构地区：[1]福州市长乐区人民医院重症医学科,福建福州350200 [2]福州市长乐区人民医院心血管内科,福建福州350200

出　　处：《中国医药科学》2024年第15期181-185,共5页China Medicine And Pharmacy

基　　金：福建省福州市科技计划项目(2021-S-135)。

摘　　要：目的分析脓毒症患者采用连续性肾脏替代疗法(CRRT)与血液灌流(HP)联合治疗的效果,探讨其对生化指标水平和炎症介质的影响。方法选取2021年1月至2023年9月福州市长乐区人民医院重症医学科收治的60例脓毒症患者作为研究对象,按随机数表法分为两组,对照组(n=30)给予CRRT治疗,观察组(n=30)给予CRRT联合HP治疗。比较两组患者的血清炎症介质、生化指标、治疗效果等。结果治疗3 d后,观察组血清C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)水平均低于对照组,差异有统计学意义(P<0.05);观察组乳酸、天冬氨酸转氨酶(AST)生化指标水平低于对照组,差异有统计学意义(P<0.05);治疗后,观察组全身性感染相关器官功能衰竭(SOFA)评分、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分低于对照组,差异有统计学意义(P<0.05)。结论CRRT联合HP治疗脓毒症,可有效减轻患者炎症介质,调节生化指标,促进器官功能恢复,有利于提高治疗效果,具有重要的研究价值。Objective To analyze the effect of continuous renal replacement therapy(CRRT)combined with hemoperfusion(HP)in patients with sepsis,and to explore its influence on biochemical indexes and inflammatory mediators.Methods A total of 60 sepsis patients admitted to the Department of Critical Care Medicine of People’s Hospital of Changle District in Fuzhou City from January 2021 to September 2023 were selected as the research objects and divided into two groups by random number table method.The control group(n=30)was given CRRT treatment,while the observation group(n=30)was given CRRT combined with HP treatment.The serum inflammatory mediators,biochemical indexes and therapeutic effects and so on were compared between the two groups.Results After 3 days of treatment,the serum levels of C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and procalcitonin(PCT)in the observation group were all lower than those in the control group,with statistically significant differences(P<0.05).The biochemical indexes of lactic acid and aspartate transaminase(AST)in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).After treatment,the scores of systemic infection related organ failure(SOFA)and acute physiology and chronic health evaluationⅡ(APACHEⅡ)in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).Conclusion CRRT combined with HP in the treatment of sepsis can effectively reduce inflammatory mediators,adjust biochemical indexes and promote the recovery of organ function,which is beneficial to improve the therapeut ic effect and has important research value.

关 键 词：脓毒症 联合治疗 连续性肾脏替代疗法 血液灌流 炎症介质 生化指标 

分 类 号：R459.7[医药卫生—急诊医学]