摘要
目的观察连续性血液净化治疗脓毒症合并急性肾损伤患者效果及对免疫和炎症因子影响。方法选取2018年5月—2020年5月南通大学第二附属医院ICU收治的86例脓毒症合并急性肾损伤患者,按随机数字表法分为连续性血液净化组(43例,接受连续性血液净化治疗)及间歇性血液透析组(43例,接受间歇性血液透析治疗)。观察两组治疗后效果、肾功能、微循环、免疫功能及炎症反应情况。结果连续性血液净化组病死率与间歇性血液透析组差异无统计学意义(P>0.05),连续性血液净化组肾功能恢复正常率、APACHEⅡ评分降低值高于间歇性血液透析组(P<0.05)。治疗前两组肾功能、T淋巴细胞、炎症指标以及微循环指标差异不大(P>0.05)。治疗14 d后,两组肾功能、T淋巴细胞、炎症指标以及微循环指标均较治疗前改善(P<0.05),且连续性血液净化组Scr、BUN均低于间歇性血液透析组(P<0.05);连续性血液净化组TVD低于间歇性血液透析组(P<0.05),MFI高于间歇性血液透析组(P<0.05);连续性血液净化组CD3+、CD4+、CD4+/CD8+高于间歇性血液透析组(P<0.05);连续性血液净化组CRP、IL-6低于间歇性血液透析组(P<0.05)。结论连续性血液净化治疗脓毒症合并急性肾损伤可显著改善患者预后,调节微循环、免疫功能,降低炎症反应。
Objective To observe the effect of continuous blood purification on patients with sepsis and acute kidney injury and its effects on immune and inflammatory factors.Methods 86 patients with sepsis and acute kidney injury admitted to Second Affiliated Hospital of Nantong University,from May 2018 to May 2020 were divided into continu⁃ous blood purification group(43 cases,receiving continuous blood purification treatment)and intermittent hemodialy⁃sis group(43 cases,receiving intermittent hemodialysis treatment)according to random number table method And.The effect,renal function,microcirculation,immune function and inflammation of the two groups were observed.Re⁃sults There was no statistically significant difference between the mortality rate of the continuous blood purification group and the intermittent hemodialysis group(P>0.05).The rate of normalization of renal function and the decrease in APACHE II score of the continuous blood purification group were higher than those of the intermittent hemodialysis group(P<0.05).There was no significant difference in renal function,T lymphocytes,inflammation indexes and micro⁃circulation indexes between the two groups before treatment(P>0.05).After 14 days of treatment,the renal function,T lymphocytes,inflammation indicators and microcirculation indicators of the two groups were improved compared with before treatment(P<0.05),and the Scr and BUN of the continuous blood purification group were lower than those of the intermittent hemodialysis group(P<0.05);TVD in continuous blood purification group was lower than intermittent he⁃modialysis group(P<0.05),and MFI was higher than intermittent hemodialysis group(P<0.05);CD3+,CD4+,CD4+/CD8+was higher than the intermittent hemodialysis group(P<0.05);the CRP and IL-6 in continuous blood purification group were lower than intermittent hemodialysis group(P<0.05).Conclusion Continuous blood purification treatment in sepsis patients with acute kidney injury can significantly improve the prognosis of patients,regulate microcirculation and immune function,and reduce inflammation.
作者
赵云峰
徐志华
顾维立
ZHAO Yunfeng;XU Zhihua;GU Weili(Department of Critical Care Medicine,Second Affiliated Hospital of Nantong University,Nantong Jiangsu 226000)
出处
《中国急救复苏与灾害医学杂志》
2021年第8期895-898,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
南通市市级科技计划指导性项目(编号:JCZ20084)。
关键词
连续性血液净化
脓毒症
急性肾损伤
免疫功能
炎症反应
Continuous blood purification
Sepsis
Acute kidney injury
Immune function
Inflammation
作者简介
通信作者:顾维立,E-mail:guweili1980@163.com。
