连续性血液透析滤过联合血液灌流治疗急性肾损伤的疗效及对血清神经导向因子-1、肾损伤因子-1水平的影响  

Efficacy of continuous venovenous hemodiafiltration combined with hemoperfusion in the treatment of acute kidney injury and its influence on levels of serum nerve guidance factor-1 and kidney injury factor-1

作　　者：高晓霞[1] 赵敏[2] 杨宇莹 李吉明[2] Gao Xiaoxia;Zhao Min;Yang Yuying;Li Jiming(Department of Emergency Trauma Center,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China;Department of Emergency Intensive Care Unit,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]新疆医科大学第一附属医院急救创伤中心,乌鲁木齐830000 [2]新疆医科大学第一附属医院急救重症监护室,乌鲁木齐830000

出　　处：《中国医师进修杂志》2024年第12期1081-1085,共5页Chinese Journal of Postgraduates of Medicine

基　　金：新疆维吾尔自治区卫生健康委员会资助项目(WJWY-202017)。

摘　　要：目的探讨连续性血液透析滤过(CVVHDF)联合血液灌流治疗急性肾损伤(AKI)的疗效及对血清神经导向因子-1(Netrin-1)、肾损伤因子-1(Kim-1)水平的影响。方法前瞻性选取2018年1月至2021年1月新疆医科大学第一附属医院诊治的193例AKI患者,按随机数字表法分为对照组(96例)和观察组(97例),对照组给予常规治疗,观察组在常规治疗的基础上给予CVVHDF联合血液灌流治疗,比较两组治疗前后Netrin-1、Kim-1及肾功能指标、危重症评分、炎性因子水平。结果观察组治疗后72 h血清Netrin-1、Kim-1、血肌酐、尿素氮水平低于对照组[(5.43±0.61)ng/L比(7.52±0.83)ng/L、(0.97±0.23)ng/L比(1.52±0.29)ng/L、(97.58±8.51)μmol/L比(109.80±7.56)μmol/L、(5.72±1.19)mmol/L比(7.40±1.75)mmol/L],差异有统计学意义(P<0.05)。观察组治疗后72 h急性生理学和慢性健康状况评估Ⅱ、多器官功能障碍综合征评分低于对照组[(14.26±5.62)分比(16.82±3.75)分、(7.15±0.86)分比(8.23±0.92)分],差异有统计学意义(P<0.05)。观察组治疗后72 h血清肿瘤坏死因子-α、白细胞介素6、C反应蛋白水平均低于对照组[(13.26±4.06)ng/L比(29.30±5.81)ng/L、(14.56±3.29)ng/L比(29.88±5.40)ng/L、(12.06±3.43)mg/L比(33.82±4.94)mg/L],差异有统计学意义(P<0.05)。结论CVVHDF联合血液灌流治疗AKI可有效改善患者肾功能,降低血清炎性因子水平,缓解病情,促进恢复。ObjectiveTo explore the efficacy of continuous venovenous hemodiafiltration(CVVHDF)combined with hemoperfusion in the treatment of acute kidney injury(AKI)and its influence on the levels of serum nerve guidance factor-1(Netrin-1)and kidney injury factor-1(Kim-1).MethodsA total of 193 patients with AKI diagnosed and treated in the First Affiliated Hospital of Xinjiang Medical University from January 2018 to January 2021 were prospectively selected and divided into the control group(96 cases)and the observation group(97 cases)according to random number table method.The control group was given conventional treatment,and the observation group was given CVVHDF combined with hemopirrigation on the basis of conventional treatment.The levels of Netrin-1,Kim-1,renal function index,critical disease score and inflammatory response index before and after treatment were compared between the two groups.ResultsAfter 72 h of treatment,the serum levels of Netrin-1,Kim-1,creatinine and urea nitrogen in the observation group were lower than those in the control group:(5.43±0.61)ng/L vs.(7.52±0.83)ng/L,(0.97±0.23)ng/L vs.(1.52±0.29)ng/L,(97.58±8.51)μmol/L vs.(109.80±7.56)μmol/L,(5.72±1.19)mmol/L vs.(7.40±1.75)mmol/L,there were statistical differences(P<0.05).After 72 h of treatment,the scores of acute physiology and chronic health evaluationⅡand multiple organ dysfunction syndrome in the observation group were lower than those in the control group:(14.26±5.62)scores vs.(16.82±3.75)scores,(7.15±0.86)scores vs.(8.23±0.92)scores,there were statistical differences(P<0.05).After 72 h of treatment,the levels of tumor necrosis factor-α,interleukin-6 and C-reactive protein in the observation group were lower than those in the control group:(13.26±4.06)ng/L vs.(29.30±5.81)ng/L,(14.56±3.29)ng/L vs.(29.88±5.40)ng/L,(12.06±3.43)mg/L vs.(33.82±4.94)mg/L,there were statistical differences(P<0.05).ConclusionsCVVHDF combined with hemoperfusion can effectively improve the renal function of patients with AKI,reduce the levels o

关 键 词：急性肾损伤 血液透析滤过 血液灌流 神经导向因子-1 肾损伤因子-1 

分 类 号：R692[医药卫生—泌尿科学]