连续性肾脏替代治疗急性肾功能衰竭疗效及对T淋巴细胞炎症因子和血清电解质水平的影响被引量：12

Efficacy of Continuous Renal Replacement Therapy on Acute Renal Failure and Its Effects on Levels of T Lymphocytes Inflammatory Factors and Serum Electrolytes

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摘要目的:观察连续性肾脏替代治疗(CRRT)急性肾功能衰竭(ARF)疗效及对T淋巴细胞、炎症因子和血清电解质水平的影响。方法:将我院收治的161例ARF患者采用简单随机抽样法分为观察组(n=81)与对照组(n=80)。在常规治疗基础上,对照组患者采用间歇性血液透析(IHD)治疗,观察组患者采用CRRT治疗。比较两组患者临床疗效,观察治疗前、治疗3个月后两组患者免疫功能指标(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、炎症因子[白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)及肿瘤坏死因子-α(TNF-α)]、血清电解质[钾(K^(+))、钠(Na^(+))、氯(Cl^(-))]、肾功能指标[血尿素氮(BUN)、血清肌酐(Scr)、内生肌酐清除率(Ccr)、β2微球蛋白(β2-MG)]变化情况。结果:观察组患者临床总有效率(96.3%)明显高于对照组(87.5%)(P<0.05)。治疗3个月后,两组患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、Ccr水平均高于治疗前,且两组治疗前后差值组间比较,差异具有统计学意义(P<0.05);两组患者CD8^(+)、IL-1、IL-6、IL-8、TNF-α、K^(+)、Na^(+)、Cl^(-)、BUN、Scr、β2-MG水平水平均低于治疗前,且两组治疗前后差值组间比较,差异具有统计学意义(P<0.05)。结论:CRRT治疗ARF患者效果显著,可降低患者炎性因子水平,调节电解质水平,提高机体免疫力,改善肾功能。 Objective:To observe the efficacy of continuous renal replacement therapy(CRRT)on acute renal failure(ARF)and its effects on levels of T lymphocytes,inflammatory factors and serum electrolytes.Methods:A total of 161 patients with ARF treated in the hospital were randomly divided into observation group(n=81)and control group(n=80)according to simple random sampling.On the basis of conventional treatment,patients in control group were treated with intermittent hemodialysis(IHD),and patients in observation group were administered CRRT.The clinical efficacy of the two groups of patients was compared,and the changes in immune function indicators(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),inflammatory factors[interleukin-1(IL-1),interleukin-6(IL-6),interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)],serum electrolytes[potassium(K^(+)),sodium(Na^(+)),chlorine(Cl^(-))]and renal function indicators[blood urea nitrogen(BUN),serum creatinine(Scr),endogenous creatinine clearance rate(Ccr),β2 microglobulin(β2-MG)]were observed in the two groups before treatment and after 3 months of treatment.Results:The total clinical effective rate of observation group was significantly higher than that of control group(96.3%vs 87.5%)(P<0.05).After 3 months of treatment,the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)and Ccr in the two groups of patients were higher than those before treatment,and the differences before and after treatment between the two groups were statistically significant(P<0.05).The levels of CD8^(+),IL-1,IL-6,IL-8,TNF-α,K^(+),Na^(+),Cl^(-),BUN,Scr and β2-MG were lower in the two groups of patients than those before treatment,and the differences before and after treatment were statistically significant between the two groups(P<0.05).Conclusion CRRT has a significant effect in the treatment of patients with ARF.It can reduce the levels of inflammatory factors,regulate the levels of electrolytes,enhance the body’s immunity,and improve the renal function.