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投稿时间：2018-09-12 网络发布日期：2019-06-20
投稿时间：2018-09-12 网络发布日期：2019-06-20
中文摘要: 目的 探讨连续性肾脏替代疗法(CRRT)在重症多脏器功能衰竭患者中的临床疗效及炎症控制情况。方法 选择2013年1月至2018年5月治疗的重症多脏器功能衰竭患者100例作为研究对象,按随机数字表法分为对照组(n=50)和观察组(n=50)。对照组给予间歇性血液透析(IHD)治疗,观察组采用CRRT治疗,1个月治疗后对患者疗效进行评估。采用7600型全自动生化分析仪测定两组治疗前、治疗后1个月血尿素氮(BUN)、肌酐(Scr)、血钾(K+)、血钠(Na+)、血氯(Cl-)水平；采用血气分析测定两组治疗前、治疗后1个月二氧化碳结合力、血pH值水平；采用酶联免疫吸附试验测定两组治疗前、治疗后1个月白细胞介素(IL)-6、IL-8、IL-10及肿瘤坏死因子(TNF)-α水平；治疗后对患者进行12个月随访,用直接计算法统计两组治疗后1、3、6、9及12个月死亡率,比较两组临床疗效及炎症控制情况。结果 治疗后1个月,观察组BUN、Scr、K+、Na+水平均低于对照组(P<0.05),Cl-水平高于对照组(P<0.01)；二氧化碳结合力、血pH值均高于对照组(P<0.01),IL-6、IL-8、IL-10及TNF-α水平,均低于对照组(P<0.01)。观察组与对照组治疗后1、3、6个月死亡率差异无统计学意义(P>0.05)；观察组治疗后9及12个月死亡率均低于对照组(P<0.05)。结论 将CRRT用于重症多脏器功能衰竭患者中能改善患者肾功能、生化指标水平,有助于降低炎症因子水平,降低临床病死率。
Abstract:ObjectiveTo investigate the effects of CRRT on clinical thertment and inflammation control in patients with severe multiple organ failure(MOF). Methods One hundred MOF patients treated from January 2013 to May 2018 were selected as subjects and randomly divided into control group and observation group (n=50,each).The intermittent hemodialysis (IHD) was given in control group,while CRRT was performed in observation group.The therapeutic effect was evaluated in two groups after one month of treatment.Before and one month after treatment,the levels of blood urea nitrogen (BUN),creatinine (Scr),serum potassium (K+),sodium (Na+) and chlorine (Cl-) were measured using 7600 automatic biochemical analyzer;the carbon dioxide binding capacity and blood pH level were determined by blood gas analyzer;the levels of interleukin(IL)-6,IL-8,IL-10 and tumor necrosis factor-α (TNF-α) were detected by enzyme-linked immunosorbent assay(ELISA).The patients were followed up for 12 months after treatment,and the mortality rates at 1-,3-，6-,9- and 12-month after treatment were recorded to compare the clinical effects and inflammation control between two groups. Results At one month after treatment,the levels of BUN,Scr,K+ and Na+ decreased,and the level of Cl- increased in observation group compared with control group (all P<0.05);CO2 binding capacity and blood pH value were significantly higher in observation group than those in control group (all P<0.05);the levels of IL-6,IL-8,IL-10 and TNF-α in observation group were significantly lower than those in control group (all P<0.05).There were no significant differences in mortality rates at 1-,3- and 6- month after treatment between two groups (P>0.05),however,the mortality rates at 9-,12-month after treatment in observation group were statistically lower than those in control group (P<0.05). Conclusion In treatment for patients with severe MOF,CRRT can improve the renal function and biochemical indicators and help to reduce the levels of inflammatory factors and clinical mortality.
keywords: Continuous renal replacement therapy Intermittent hemodialysis Severe multiple organ failure Renal function Biochemical indicators Inflammatory factors Mortality
文章编号： 中图分类号： 文献标志码：A
基金项目:天津市卫生局攻关课题(2016G132)
| Author Name | Affiliation |
| MENG Xiang-zhong,WEI Qiong,ZHU Yu,XU Chou | Intensive Care Unit,No.983 Hospital of Joint Logistics Support Force of PLA,Tianjin 300142,China |
引用文本：
孟祥忠,魏琼,朱宇,徐绸.连续性肾脏替代疗法治疗重症患者多脏器功能衰竭[J].中国临床研究,2019,32(6):759-762.
孟祥忠,魏琼,朱宇,徐绸.连续性肾脏替代疗法治疗重症患者多脏器功能衰竭[J].中国临床研究,2019,32(6):759-762.