摘要
目的观察CBPT对重症肺炎合并急性肾损伤（AKI）患者免疫功能的影响。方法选择2010年8月至2011年6月入住广西医科大学第一附属医院的30例重症肺炎合并急性肾损伤患者，予不同剂量的CBPT，观察治疗前后患者心率（HR）、平均动脉压（MAP）、血清肌酐（SCr）、C反应蛋白（CRP）、淋巴细胞CIM＋／CD8＋比值、中性粒细胞吞噬率及吞噬指数的变化。结果治疗后患者平均动脉压与治疗前相比均没有统计学意义（P〉0．05）；心率（HR）、血清肌酐（SCr）均较治疗前有所下降（P〈0．05）；CRP水平治疗后均较治疗前下降（P〈0．05），其中大剂量组较中、小剂量组下降明显（P〈0．05）；治疗后淋巴细胞CD4＋／CD8＋比值均较治疗前升高（P〈0．05）；治疗后患者中性粒细胞吞噬率及吞噬指数均增加（P〈0．05），且大剂量组较中、小剂量组增加明显（P〈0．05），中剂量组较小剂量组增加明显（P〈0．05）。结论CBPT对重症肺炎合并急性肾损伤患者平均动脉压影响不大，血流动力学稳定，能够有效清除肌酐等小分子物质，降低血清CRP水平，提高淋巴细胞CD4＋／CD8＋比值，增强中性粒细胞吞噬功能，改善患者免疫功能，
Objectives To observe the effects of different doses of continuous blood purification therapy on immune function of patients with severe pneumonia and acute kidney injury （AKI）. Methods A total of 30 pa- tients diagnosed with severe pneumonia and AKI were selected in this study, who stayed in our intensive care unit in the period of August 2010 to June 2011. They were randomly divided into three groups and received different doses of daytime Continuous Renal Replacement Therapy for 12 hours . The first group who were treated by daytime CRRT with the uhrafiltration rate at 100 ml/（ kg ~ h）were considered as the high -dose group, the second group who were treated by daytime CRRT with the uhrafiltration rate at 65 ml/（ kg ~ h） were considered as the middle - dose group, and the last group who were treated by daytime CRRT with the ultrafiltration rate at 35 ml/（ kg ~ h） were considered as the low- dose group. Heart rate（HR） ,mean arterial pressure（ MAP）, serum creatinine（sCr） ,C reactive protein （CRP） ,lymphocyte CD4 ＋/CD8 ~ ,the phagocytosis rates and phagocytosis indexes of polymorphonuclear neutrophil （PMN）. Resuits In all patients, the changes of MAP were not statistically significant （ P 〉 0.05 ）. Compared with pre - treatment, HR（ P 〈 0.05 ） and sCr（ P 〈 0.05 ） were decreased after the treatment,but the differences a- mong 3 dose groups were not statistically significant（ P 〉 0.05 ）. Serum levels of CRP were also decreased after the treatment（ P 〈 0.05）, and the level in high- dose group decreased most rapidly in 3 groups （ P 〈 0.05）, the changes did not differ between middle - dose group and low - dose group （ P 〉 0. 05 ）. Lymphocyte CD4 ＋/CO8 ＋ was increased after the treatment（ P 〈 0.05 ）, but the differences among 3 dose groups were not statistically signifi- cant（ P 〉0.05）. The phagocytosis rates （ P 〈 0.05 ） and phagocytosis indexes （ P 〈 0.05 ）of PMN were in- creased, the level in high - dose group
出处
《国际泌尿系统杂志》
2013年第1期40-44,共5页
International Journal of Urology and Nephrology
关键词
肺炎
肾
Pneumonia
Kidney
