摘要
目的观察高容量连续性血液滤过（HVHF）对多脏器功能衰竭患者C-反应蛋白的影响，初步探讨HVHF在MODS治疗中的作用及其机制。方法MODS患者随机分CVVH组，应用CVVH治疗，置换液流速为2L／h；HVHF组应用HVHF治疗，置换液流速为5—7L／h。分别检测两组患者治疗前、后每12小时段血清C-反应蛋白水平，比较两组患者血CRP水平在各个时间点有无显著性差异。结果在HVHF治疗期间，血清CRP水平逐渐降低，以治疗后72h下降最为明显，与治疗前、治疗后12h和48h比较均具有显著性差异（P均〈0．01）。HVHF组与CVVH组比较，各时间点CRP水平均较CVVH组显著降低，二者比较具有显著性差异。结论HVHF治疗后CRP水平下降更为迅速，其机制可能与HVHF清除炎症因子，减轻MODS患者体内炎症反应有关；连续的CRP检测有助于判断MODS患者的HVHF治疗的预后。
Objective To evaluate the influence of continuous high-volume hemofihration （HVHF） on serum C-reactive protein （CRP） levels in MODS patients and explore the effect and the mechanism of HVHF on the treatment of MODS patients. Mehods Fifteen MODS patients （9 males and 6 females） with an average age of 32 - 76 （50. 8 ± 16. 7 ） were randomly divided into two groups： CVVH group （n =6） and HVHF group （n =9） ; the patients in CVVH group were received the treatment of HVHF; the patients in HVHF group were received the treatment of HVHF. The serum CRP level were measured before and after the treatment of CVVH and HVHF per 12 houres respectively. Results CRP level decreased markedly in the patients received the treatment of HVHF. 72 h after HVHF, it was significantly lower than pretreatment （ P 〈0. 01 ） , and very significantly lower than preteatment and 12h, 48h after HVHF （ P 〈 0. 01 ） , While in CVVH group patients, CRP was decreased gradually. The CRP level of the HVHF group was significantly lower than which in the CVVH group patients respectively. Condusion HVHF was effective in decreasing the acute-phase reactant CRP level in the MODS patients. Sequential determination of CRP serum levels in MODS patients treated with HVHF is of clinical significance in the evaluation of the prognosis.
出处
《广州医药》
2007年第2期52-54,共3页
Guangzhou Medical Journal
