连续肾脏替代疗法结合液体复苏对脓毒血症伴急性肾损伤患者肾功能、免疫功能指标的影响  

Effects of continuous renal replacement therapy combined with fluid resuscitation on renal function and immune function indexes in patients with sepsis and acute kidney injury

作　　者：易柳青 梁银娇 YI Liu-qing;LIANG Yin-jiao(Department of Critical Care Medicine,Zhangzhou Hospital of Traditional Chinese Medicine,Zhangzhou 363000,China)

机构地区：[1]福建省漳州市中医院重症医学科,363000

出　　处：《中国现代药物应用》2025年第7期48-51,共4页Chinese Journal of Modern Drug Application

摘　　要：目的 探究在脓毒血症伴急性肾损伤患者中实施连续肾脏替代疗法联合液体复苏对肾功能、免疫功能指标的影响。方法 185例脓毒血症伴急性肾损伤患者,按照治疗方式的不同分为对照组(n=90)和观察组(n=95)。对照组进行单纯液体复苏治疗,观察组在对照组基础上结合连续肾脏替代疗法。对比两组肾功能(血肌酐、尿素氮)、免疫功能(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))、炎症反应[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、病情严重程度[急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分]。结果 观察组治疗后血肌酐(70.22±6.54)μmol/L、尿素氮(6.10±1.18)mmol/L均较对照组的(86.46±8.55)μmol/L、(8.97±1.53)mmol/L低(P<0.05)。观察组治疗后CD3^(+)(49.33±4.02)%、CD4^(+)(39.24±3.57)%、CD4^(+)/CD8^(+)(1.52±0.32)均较对照组的(42.39±3.61)%、(30.28±3.11)%、(1.36±0.24)高(P<0.05)。观察组治疗后IL-6(30.02±3.88)pg/ml、TNF-α(8.21±1.03)μg/ml均较对照组的(46.29±5.14)pg/ml、(11.06±1.45)μg/ml低(P<0.05)。治疗后,观察组APACHEⅡ评分(20.10±1.89)分低于对照组的(23.15±2.10)分(t=10.394, P=0.000<0.05)。结论 连续肾脏替代疗法结合液体复苏能够有效改善脓毒血症伴急性肾损伤患者肾功能、免疫功能,减轻炎症反应,加快病情恢复。Objective To explore the effects of continuous renal replacement therapy combined with fluid resuscitation on renal function and immune function indexes in patients with sepsis and acute kidney injury.Methods According to different treatment methods,185 patients with sepsis and acute kidney injury were divided into control group(n=90)and observation group(n=95).The control group received liquid resuscitation alone,and the observation group was combined with continuous renal replacement therapy on the basis of the control group.Both groups were compared in terms of renal function(serum creatinine,urea nitrogen),immune function(CD3^(+),CD4^(+),CD4^(+)/CD8^(+)),inflammatory response[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]and severity of disease[Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)score].Results After treatment,the observation group had serum creatinine of(70.22±6.54)μmol/L and urea nitrogen of(6.10±1.18)mmol/L,which were lower than(86.46±8.55)μmol/L and(8.97±1.53)mmol/L in the control group(P<0.05).After treatment,the observation group had CD3^(+)of(49.33±4.02)%,CD4^(+)of(39.24±3.57)%and CD4^(+)/CD8^(+)of(1.52±0.32),which were higher than(42.39±3.61)%,(30.28±3.11)%and(1.36±0.24)in the control group(P<0.05).After treatment,the observation group had IL-6 of(30.02±3.88)pg/ml and TNF-αof(8.21±1.03)μg/ml,which were lower than(46.29±5.14)pg/ml and(11.06±1.45)μg/ml in the control group(P<0.05).After treatment,the observation group had lower APACHEⅡscore of(20.10±1.89)points,which was lower than(23.15±2.10)points in the control group(t=10.394,P=0.000<0.05).Conclusion Continuous renal replacement therapy combined with fluid resuscitation can effectively improve renal function and immune function in patients with sepsis and acute kidney injury,reduce inflammatory response,and accelerate the recovery of the disease.

关 键 词：脓毒血症 急性肾损伤 连续肾脏替代疗法 液体复苏 肾功能 免疫功能 炎症反应 病情严重程度 

分 类 号：R459.7[医药卫生—急诊医学]