观察CRRT治疗80岁以上超高龄多器官功能衰竭（multiple organ failure in the elderly，MOFE）。患者救治的临床疗效。2001年至2009年在本中心接受CRRT治疗的59例超高龄MOFE患者，年龄80—93岁，平均（82．5±3．28）岁。观察CRRT...观察CRRT治疗80岁以上超高龄多器官功能衰竭（multiple organ failure in the elderly，MOFE）。患者救治的临床疗效。2001年至2009年在本中心接受CRRT治疗的59例超高龄MOFE患者，年龄80—93岁，平均（82．5±3．28）岁。观察CRRT疗效及治疗过程中患者生命体征变化，监测其肝、肾功能。结果表明：59例超高龄MOFE患者以病情缓解，临床治愈标准，分为存活组和死亡组两组，出院44例占75％，院内死亡组15例占25％。Continuous blood Purification在超高龄MOFE的救治，可有效缓解患者病情，保护脏器功能，提高患者存活率，治疗过程患者耐受良好，血液动力学稳定，并发症少，疗效确切。展开更多
Objective To evaluate the sensitivity of arterial ketone body ratio as an indicator for multiple organ failure.Materials and methods The experimental model of multiple organ failure was made in adult and old rats by h...Objective To evaluate the sensitivity of arterial ketone body ratio as an indicator for multiple organ failure.Materials and methods The experimental model of multiple organ failure was made in adult and old rats by hypoperfusion-induced hemorrhagic shock. After blood sampling, the arterial acetoacetate, β-hydroxybutyrate, total ketone body, ALT, AST, BUN, creatinine at 2, 4, 8 hr in hypoperfusion were examined to compare the differences of ketone body ratio and organ failure between adult and old rats. Hepatic and mitochondrial metabolism were assessed by comparing ketone body ratios (AcAc/β-OHB) and free NAD+/NADH ratios. Results Ketone body ratio in old rats at 2, 4, 8 hr after the induction of hemorrhagic shock decreased from 0.68 to 0.31, 0.27 and 0.22, respectively. In adult rats, it decreased from 1.12 to 0.17, 0.12 and 0.09, respectively. Changes of ketone body ratio in the adult group were larger than in the elderly group ( P ＜ 0.001). The development of multiple organ failure is associated with the time of hemorrhagic shock development. Conclusions There was a different ketone body ratio between multiple organ failure in the elderly (MOFE) and multiple organ failure (MOF) in general adults. Ketone body ratio is a better indicator than ALT and AST in reflecting hepatic function in the early status of MOF. (J Geriatr Cardiol 2004;1(2) :125-128. )展开更多
目的观察连续性静脉-静脉血液透析滤过（CVVHDF）用于老年多器官功能衰竭（multi-ple organ failure in the elderly，MOFE）患者的临床疗效。方法15例MOFE患者，年龄63～87（72．9±5．6）岁。观察CVVHDF治疗前后患者SIRS指标（体...目的观察连续性静脉-静脉血液透析滤过（CVVHDF）用于老年多器官功能衰竭（multi-ple organ failure in the elderly，MOFE）患者的临床疗效。方法15例MOFE患者，年龄63～87（72．9±5．6）岁。观察CVVHDF治疗前后患者SIRS指标（体温、心率、呼吸、动脉血二氧化碳分压及外周血白细胞总数）的改变，监测其肾功能、电介质、动脉血气、中心静脉压的变化。结果CVVHDF治疗后患者SIRS反应明显减轻，血管活性药物逐渐减量，13例机械通气患者6例成功撤离呼吸机，3例心跳呼吸骤停患者2例神志转清。血清尿素氮、肌酐、血钾较治疗前显著降低，低氧血症、酸中毒、心衰得到纠正，治疗前、后比较差异有显著性（P〈0．05）。结论CVVHDF治疗MOFE患者，可明显抑制患者SIRS反应，全面改善心肺脑肾功能，是MOFE患者重要的治疗手段之一。展开更多
文摘观察CRRT治疗80岁以上超高龄多器官功能衰竭（multiple organ failure in the elderly，MOFE）。患者救治的临床疗效。2001年至2009年在本中心接受CRRT治疗的59例超高龄MOFE患者，年龄80—93岁，平均（82．5±3．28）岁。观察CRRT疗效及治疗过程中患者生命体征变化，监测其肝、肾功能。结果表明：59例超高龄MOFE患者以病情缓解，临床治愈标准，分为存活组和死亡组两组，出院44例占75％，院内死亡组15例占25％。Continuous blood Purification在超高龄MOFE的救治，可有效缓解患者病情，保护脏器功能，提高患者存活率，治疗过程患者耐受良好，血液动力学稳定，并发症少，疗效确切。
文摘Objective To evaluate the sensitivity of arterial ketone body ratio as an indicator for multiple organ failure.Materials and methods The experimental model of multiple organ failure was made in adult and old rats by hypoperfusion-induced hemorrhagic shock. After blood sampling, the arterial acetoacetate, β-hydroxybutyrate, total ketone body, ALT, AST, BUN, creatinine at 2, 4, 8 hr in hypoperfusion were examined to compare the differences of ketone body ratio and organ failure between adult and old rats. Hepatic and mitochondrial metabolism were assessed by comparing ketone body ratios (AcAc/β-OHB) and free NAD+/NADH ratios. Results Ketone body ratio in old rats at 2, 4, 8 hr after the induction of hemorrhagic shock decreased from 0.68 to 0.31, 0.27 and 0.22, respectively. In adult rats, it decreased from 1.12 to 0.17, 0.12 and 0.09, respectively. Changes of ketone body ratio in the adult group were larger than in the elderly group ( P ＜ 0.001). The development of multiple organ failure is associated with the time of hemorrhagic shock development. Conclusions There was a different ketone body ratio between multiple organ failure in the elderly (MOFE) and multiple organ failure (MOF) in general adults. Ketone body ratio is a better indicator than ALT and AST in reflecting hepatic function in the early status of MOF. (J Geriatr Cardiol 2004;1(2) :125-128. )
文摘目的观察连续性静脉-静脉血液透析滤过（CVVHDF）用于老年多器官功能衰竭（multi-ple organ failure in the elderly，MOFE）患者的临床疗效。方法15例MOFE患者，年龄63～87（72．9±5．6）岁。观察CVVHDF治疗前后患者SIRS指标（体温、心率、呼吸、动脉血二氧化碳分压及外周血白细胞总数）的改变，监测其肾功能、电介质、动脉血气、中心静脉压的变化。结果CVVHDF治疗后患者SIRS反应明显减轻，血管活性药物逐渐减量，13例机械通气患者6例成功撤离呼吸机，3例心跳呼吸骤停患者2例神志转清。血清尿素氮、肌酐、血钾较治疗前显著降低，低氧血症、酸中毒、心衰得到纠正，治疗前、后比较差异有显著性（P〈0．05）。结论CVVHDF治疗MOFE患者，可明显抑制患者SIRS反应，全面改善心肺脑肾功能，是MOFE患者重要的治疗手段之一。
