摘要
目的探讨连续性肾脏替代治疗(continuous renal replacement therapy,CRRT)对重症肺炎所致急性肾损伤患者TLR2和TLR4的影响。方法选择2014年6月-2015年12月入住新疆医科大学附属中医医院重症监护病房的10例重症肺炎合并急性肾损伤患者,男性8例,女性2例,随机分为常规治疗组及常规治疗+CRRT治疗组,每组5例,健康志愿者(健康组)5例。比较各组治疗前与治疗4、8、12、24h时血清肌酐、尿素氮、尿酸及TLR2和TLR4的差异。结果 (1)常规治疗组和常规治疗+CRRT治疗组治疗前与治疗4、8、12、24h时尿素氮、血肌酐、血尿酸水平与健康组比较,差异均有统计学意义(P<0.05);予以常规治疗及常规治疗+CRRT治疗后上述指标较治疗前无明显变化。(2)治疗前常规治疗组、常规治疗+CRRT组TLR2和TLR4水平明显高于健康组,差异有统计学意义(P<0.05)。随着治疗时间的延长,常规治疗组、常规治疗+CRRT组治疗4、8、12、24h时点的TLR2和TLR4水平均有所下降,常规治疗+CRRT组TLR2和TLR4水平下降较常规治疗组明显,其中治疗12h时点下降最为明显,治疗24h较12h略有升高。结论常规+CRRT治疗改善重症肺炎所致急性肾损伤较常规治疗无优势,联合CRRT治疗可降低患者体内TLR2和TLR4水平,改善体内炎症状态,其中以12h时点最显著。
Objective To investigate the influence of continuous renal replacement therapy(renal replacement therapy continuous,CRRT)over TLR2 and TLR4in patients with acute kidney injury caused by severe pneumonia.Methods Enrolled were the 10 cases of patients hospitalized in Xinjiang Medical University Affiliated Hospital of Traditional Chinese Medicine in ICU from June 2014-December 2015 with severe pneumonia and acute kidney injury.Of the 10 cases,8were male,2were female.subsequently they were randomly divided into conventional treatment group and conventional together with CRRT treatment group,with 5cases in each group.Additionally,5cases of healthy volunteers were enrolled as healthy control..Compared were the concentration level of the serum creatinine,urea nitrogen,uric acid and expression variation of both TLR2 and TLR4before and after treatment at 4,8,12 hand 24h.Results(1)the difference of level of urea nitrogen,serum creatinine and blood uric acid were shown to be statistically significant between the two groups after treatment for 4,8,12,24h(P <0.05);whereas no significant difference was observed between the two groups before treatment;(2)expression level of TLR2 and TLR4in the two groups were observed to be significantly higher than that of healthy control group before treat-ment(P <0.05).However,with the extension of therapy time,both TLR2 and TLR4were shown to be decreased gradually.There was significant difference of decreased TLR2 and TLR4 between the two groups.Strikingly,the decreasing of TLR2/4at 12 hafter treatment was most significant of all.While,the level of TLR2/4were displayed to be slightly on the rise at 24 hafter treatment.Conclusion No advantage in terms of therapy effect was observed between conventional treatment group and conventional treatment together with CRRT treatment group.In conjunction with CRRT treatment was observed to be able to decrease the expression level of TLR2 and TLR4,thereby ameliorating the inflammatory status.Of note,in our study,the decreasing TLR2/4was most significant of all at 12 hpost treatment.
出处
《新疆医科大学学报》
CAS
2017年第2期188-191,共4页
Journal of Xinjiang Medical University
基金
新疆医科大学附属中医医院院级课题(ZYY201304)
