连续性血液净化对多发伤合并多脏器功能障碍综合征患者外周血细胞因子的影响  

Effect of continuous blood purification on the plasma cytokines in the patients with multiple injuries and multiple organ dysfunction syndrome

作　　者：赵英萍[1] 李超[1] 姜松青[1] 廖琼[1] 刘玉琪[1] 寇秋野[1] 陈艳霞[1] 叶婷香[1] 罗向明[1] 梁细妹[1] 

机构地区：[1]广东省江门市中心医院,广东江门529070

出　　处：《河北医学》2003年第2期103-105,共3页Hebei Medicine

摘　　要：目的 :应用连续性血液净化 (CBP)技术 ,探讨其对多发伤合并多脏器功能障碍综合征(MODS)患者外周血细胞因子的影响。方法 :2 5例严重多发伤合并MODS患者经中心静脉插管留置单针双腔导管 ,使用BaxterBM2 5机器行高容量连续性静脉 -静脉血液滤过 (Hv -CVVH)方式治疗。于CBP治疗前和治疗后 2h、4h、6h、8h时分别抽取静脉血 ,采用ELISA法测定血浆TNF -α、IL - 1、IL - 8的含量 ,并在每日早晨抽取静脉血检测Bun、Scr、K+ 的浓度 ,同时抽取动脉血作血气分析。结果 :2 5例患者CBP后血清Bun、Scr、K+ 均逐渐明显下降 (P <0 .0 5或 <0 .0 1) ,血浆TNF -α、IL - 1、IL - 8水平均逐渐降低 (P <0 .0 5 ) ,血浆IL - 6水平在CBP前后均无统计学差异 (P >0 .0 5 )。结论 :CBP能清除多发伤合并MODS患者血浆中多种细胞因子 。Objective: To investigate the effect of continuous blood purification(CBP) on the plasma cytokines in the patients with multiple injuries and multiple organ dysfunction syndrome(MODS). Methods: 25 patients were satisfied the criteria of multiple injuries and MODS. A double trunk catheter was put into the central vein and the highvolume continuous veno-venous hemofiltration(Hv-CVVH) was performed with the Baxter BM25 CBP. The plasma TNF-α,IL-1 ,IL-6 and IL-8 were measured by ELISA at 0,2,4,6,8h following CBP, and the levels of BUN,Scr ,serum K + and arterial blood gas were measured in each morning .Results: The levels of BUN,Scr and serum K + decreased significantly following CBP(P<0.05 or <0.01). The plasma concentrations of TNF-α,IL-1 and IL-8 decreased gradually with the marked reduction(P<0.05).There was no significant difference in the plasma concentration of IL-6 at any time following CBP compared with those before CBP(P>0.05). Conclusion: CBP could remove many inflammatory cytokines in plasma,and improve the blood biochemical markers including BUN,Scr and serum K + in patients with multiple injuries and MODS.

关 键 词：连续性血液净化 细胞因子 多发伤 多脏器功能障碍综合征 

分 类 号：R459.5[医药卫生—治疗学]