高容量连续性静脉-静脉血液滤过对多器官功能障碍综合征患者外周血细胞因子的影响  

The effect of continuous high volume veno-venous hemofiltration on plasma cytokines in patients with multiple organ dysfunction syndrome

作　　者：赵英萍[1] 李超[2] 姜松青[3] 廖琼[4] 刘玉琪[1] 寇秋野[1] 叶婷香[1] 罗向明[1] 阮海刚[1] 张爽[1] 

机构地区：[1]广东省江门市中心医院ICU,529070 [2]广东省江门市中心医院外科,529070 [3]广东省江门市中心医院肾内科,529070 [4]广东省江门市中心医院中心实验室,529070

出　　处：《中华急诊医学杂志》2003年第10期661-663,共3页Chinese Journal of Emergency Medicine

摘　　要：目的　应用高容量连续性静脉 静脉血液滤过 (Hv -CVVH)技术 ,探讨其对多器官功能障碍综合征 (MODS)患者外周血细胞因子的影响。方法　 2 0例非创伤性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Hv CVVH方式治疗。于治疗前和治疗后 2、 4、 6、 8h时分别抽取静脉血 ,采用ELISA法测定血浆肿瘤坏死因子α (TNF -α)、白细胞介素 1(IL - 1)、白细胞介素 6 (IL - 6 )、白细胞介素 8(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　所有患者的Hv CVVH后血清Bun、Scr、K+ 均逐渐明显下降 (P <0 0 5或P <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　Hv CVVH能清除MODS患者血浆中多种细胞因子 ,并改善血液生化指标 。Objective To investigate the effect of continuous high volume veno-venous hemofiltration(Hv-CVVH)on the plasma cytokines in patients with multiple organ dysfunction syndrome(MODS).Methods In 20 patients with non-traumatic MODS,a double lumen catheter was put into the central vein,and the Hv-CVVH was performed with the Baxter BM25.The plasma TNF-α,IL-1,IL-6 and IL-8 were measured by ELISA at 0,2,4,6,8 h after Hv-CVVH,and the levels of BUN,Scr,serum K + and arterial blood gas were measured each morning.Results The levels of BUN,Scr and serum K + decreased significantly after Hv-CVVH(P<0.05 or P<0.01).The plasma concentrations of TNF-α,IL-1 and IL-8 gradually decreased (P<0.05).There was no significant difference in the plasma concentration of IL-6 at any time after Hv-CVVH,compared with those before Hv-CVVH(P>0.05).Conclusion Hv-CVVH can remove inflammatory cytokines in plasma,improve the blood biochemical markers,and treat the patients with MODS.

关 键 词：高容量连续性静脉-静脉血液滤过 多器官功能障碍综合征 外周血 细胞因子 测定 肿瘤坏死因子Α 

分 类 号：R459.7[医药卫生—急诊医学]