摘要
目的探讨高容量血液滤过对脓毒症多器官功能衰竭患者炎症水平及预后的影响。方法将2019年10月至2021年8月河南科技大学第一附属医院接治的脓毒症多器官功能衰竭患者共计116例纳入研究,根据随机数表法将其分为对照组与观察组,每组58例。两组均接受对症综合治疗,对照组接受连续性静脉-静脉血液滤过(CVVH)治疗,观察组接受脉冲式高容量血液滤过(PHVHF)治疗,均连续治疗48 h。于治疗前、治疗48 h时,检查并统计两组患者生物学指标和体征,采用酶联免疫吸附法检查两组炎症因子水平[白介素-6(IL-6)、白介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)];对比两组急性生理学和慢性健康状况评分系统Ⅱ(APACHE-Ⅱ)及序贯器官衰竭(SOFA)评分。治疗后随访30 d,以患者病死或随访截止时间为观察终点,统计患者预后情况。结果治疗48 h,两组血清IL-6、IL-10、TNF-α水平和APACHE-Ⅱ、SOFA评分均低于治疗前,且观察组较对照组更低(P<0.05)。随访期间,与对照组比较,观察组病死率更低(P<0.05)。结论PHVHF可显著降低患者炎症因子水平及病死率,利于改善预后。
Objective To investigate the effect of high volume hemofiltration on inflammatory level and prognosis in patients with sepsis induced multiple organ failure.Methods A total of 116 patients with sepsis and multiple organ failure who were treated in the First Affiliated Hospital of Henan University of Science and Technology from October 2019 to August 2021 were included in the study.According to the random number table method,they were divided into a control group and an observation group,58 patients in the two groups respectively.Both groups were given symptomatic comprehensive treatment.The control group was treated with continuous veno-venous hemofiltration(CVVH)and the observation group was treated with pulse high volume hemofiltration(PHVHF),both were treated continuously for 48 hours.Before and 48 hours after treatment,the biological indexes and signs of patients in the two groups were examined and counted,and the levels of inflammatory factors[interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)]were examined by enzyme-linked immunosorbent assay.The acute physiology and chronic health evaluationⅡ(APACHE-Ⅱ)and sequential organ failure assessment(SOFA)scores were compared between the two groups.The patients were followed up for 30 days after treatment,and the prognosis of the patients was counted with the end point of death or follow-up.Results After 48 hours of treatment,compared with before treatment,the levels of serum IL-6,IL-10,TNF-αand scores of APACHE-Ⅱand SOFA in the two groups were lower,and the indexes in observation group were lower than those in control group(P<0.05).During follow-up,the mortality rate of the observation group was lower than that of the control group(P<0.05).Conclusion PHVHF can significantly reduce the level of inflammatory factors and mortality,and improve the prognosis.
作者
许帅强
成丽媛
赵泽坤
XU Shuaiqiang;CHENG Liyuan;ZHAO Zekun(Department of Critical Care Medicine,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China;Blood Purification Room,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)
出处
《河南医学研究》
CAS
2022年第18期3298-3301,共4页
Henan Medical Research
