比较间歇性血液透析与连续性肾脏替代治疗对急性肾功能衰竭患者肾功能及炎症因子的影响  

Comparison of the effects of intermittent hemodialysis and continuous renal replacement therapy on renal function and inflammatory factors in patients with acute renal failure

作　　者：朱小洪 易柳青 梁银娇 ZHU Xiao-hong;YI Liu-qing;LIANG Yin-jiao(Emergency Department,Zhangzhou Hospital of Traditional Chinese Medicine,Zhangzhou 363000,China)

机构地区：[1]福建省漳州市中医院急诊科,363000 [2]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58-61,共4页Chinese Journal of Modern Drug Application

摘　　要：目的比较间歇性血液透析(IHD)与连续性肾脏替代治疗(CRRT)在急性肾功能衰竭(ARF)患者中的效果。方法选取102例ARF患者,按随机数字表法分为对照组及观察组,各51例。对照组行IHD,观察组行CRRT。比较两组临床疗效,治疗前后的肾功能指标[血肌酐(Scr)、尿素氮(BUN)、β_(2)-微球蛋白(β_(2)-MG)]、炎症因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)]及免疫功能指标(CD3^(+)、CD4^(+)、CD8^(+))水平。结果观察组治疗总有效率96.08%较对照组的82.35%高(P<0.05)。治疗后,两组Scr、BUN、β_(2)-MG均低于本组治疗前,且观察组Scr(153.27±4.29)μmol/L、BUN(12.28±1.69)mmol/L、β_(2)-MG(1.97±0.41)mg/L较对照组的(226.53±5.41)μmol/L、(16.31±2.56)mmol/L、(3.20±0.63)mg/L低(P<0.05)。治疗后,两组CRP、IL-6、IL-8、TNF-α均低于本组治疗前,且观察组CRP(10.53±1.21)mg/L、IL-6(17.34±2.02)ng/L、IL-8(6.35±1.34)ng/L、TNF-α(35.40±5.29)ng/L较对照组的(13.28±1.57)mg/L、(21.25±2.54)ng/L、(9.48±1.57)ng/L、(42.36±6.21)ng/L低(P<0.05)。治疗后,两组CD3^(+)、CD4^(+)高于本组治疗前,CD8^(+)低于本组治疗前,且观察组CD3^(+)(46.97±4.23)%、CD4^(+)(49.57±3.18)%较对照组的(40.29±3.57)%、(45.38±2.25)%高,CD8^(+)(28.42±1.67)%较对照组的(32.34±2.21)%低(P<0.05)。结论与IHD相比,CRRT更能够改善ARF患者肾功能,减轻体内炎症反应,提高免疫功能,具有一定的应用价值,可推广应用。Objective To compare the effects of intermittent hemodialysis(IHD)and continuous renal replacement therapy(CRRT)on renal function and inflammatory factors in patients with acute renal failure(ARF).Methods A total of 102 ARF patients were selected and divided into control group and observation group according to random numerical table,with 51 cases in each group.The control group received IHD,and the observation group received CRRT.Both groups were compared in terms of clinical efficacy,renal function indexes[serum creatinine(Scr),blood urea nitrogen(BUN),β_(2)-microglobulin(β_(2)-MG)],levels of inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α)]and immune function indicators(CD3^(+),CD4^(+),CD8^(+))before and after treatment.Results The total effective rate of 96.08%in the observation group was higher than 82.35%in the control group(P<0.05).After treatment,Scr,BUN andβ_(2)-MG in both groups were lower than those before treatment in this group;the observation group had Scr of(153.27±4.29)μmol/L,BUN of(12.28±1.69)mmol/L,andβ_(2)-MG of(1.97±0.41)mg/L,which were lower than(226.53±5.41)μmol/L,(16.31±2.56)mmol/L,and(3.20±0.63)mg/L in the control group(P<0.05).After treatment,CRP,IL-6,IL-8 and TNF-αin both groups were lower than those before treatment in this group;the observation group had CRP of(10.53±1.21)mg/L,IL-6 of(17.34±2.02)ng/L,IL-8 of(6.35±1.34)ng/L,and TNF-αof(35.40±5.29)ng/L,which were lower than(13.28±1.57)mg/L,(21.25±2.54)ng/L,(9.48±1.57)ng/L,and(42.36±6.21)ng/L in the control group(P<0.05).After treatment,CD3^(+)and CD4^(+)in both groups were higher than those before treatment in this group,and CD8^(+)was lower than that before treatment in this group;the observation group had CD3^(+)of(46.97±4.23)%and CD4^(+)of(49.57±3.18)%,which were higher than(40.29±3.57)%and(45.38±2.25)%in the control group;the observation group had a lower CD8^(+)of(28.42±1.67)%than(32.34±2.21)%in the control group(P<0.05).Conclusion Compa

关 键 词：急性肾功能衰竭 间歇性血液透析 连续性肾脏替代治疗 肾功能 炎症因子 免疫功能 

分 类 号：R692.5[医药卫生—泌尿科学]