连续性血液净化对SAP患者RAAS及炎症因子的影响

发布时间：2017-12-28 05:37

本文关键词：连续性血液净化对SAP患者RAAS及炎症因子的影响　出处：《中国现代医学杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的探讨连续性血液净化对重症急性胰腺炎(SAP)患者肾素-血管紧张素-醛固酮系统(RAAS)及炎症因子的影响。方法选取在该院住院治疗的重症急性胰腺炎患者64例,随机分为治疗组和对照组。治疗组在接受基础治疗的同时接受连续性血液净化治疗,对照组接受基础治疗,比较两组患者主要症状、指标恢复正常时间及治疗有效率的差异。比较两组患者治疗前和治疗后1、3和7 d时各RAAS指标和各炎症因子的差异。结果治疗组患者治疗后腹痛、恶心、C反应蛋白(CRP)、血清淀粉酶(AMS)恢复正常时间均低于对照组,且差异有统计学意义(P0.05);治疗组总的有效率(31例,91.18%)高于对照组(21例,70.0%),差异有统计学意义(P0.05)。两组在治疗后各RAAS指标与治疗前比较均降低,治疗组在治疗后1和3 d时的血管紧张素Ⅰ、血管紧张素Ⅱ、肾素、醛固酮均低于对照组,差异有统计学意义(P0.05);两组在治疗后各炎症因子与治疗前比较均降低,治疗组在治疗后1、3和7 d时的白细胞介素6(IL-6)、白细胞介素8(IL-8)、CRP均低于对照组,差异有统计学意义(P0.05);治疗组在治疗后1和3 d时的肿瘤坏死因子α(TNF-α)低于对照组,且差异有统计学意义(P0.05)。结论连续性血液净化治疗重症急性胰腺炎患者,在改善RAAS和炎症因子激活以及疗效方面均优于基础治疗。
[Abstract]:Objective to investigate the effects of continuous blood purification on the renin angiotensin aldosterone system (RAAS) and inflammatory factors in patients with severe acute pancreatitis (SAP). Methods 64 patients with severe acute pancreatitis hospitalized in the hospital were randomly divided into the treatment group and the control group. The treatment group received continuous blood purification treatment while receiving basic treatment. The control group received basic treatment. The difference between the two groups of patients' main symptoms, indicators returned to normal time and the effective rate of treatment were compared. The differences of RAAS and inflammatory factors were compared between the two groups of patients before and after treatment and 1, 3 and 7 d after treatment. The results of treatment of abdominal pain, nausea, C reaction protein groups after treatment (CRP), serum amylase (AMS) recovery time were lower than the control group, and the difference was statistically significant (P0.05); the total effective rate of treatment group (31 cases, 91.18%) was higher than the control group (21 cases, 70%), with statistical significance the difference (P0.05). The two groups after treatment in the RAAS index before treatment were decreased in the treatment group after treatment of 1 and 3 D of angiotensin, angiotensin II, renin and aldosterone were lower than the control group, the difference was statistically significant (P0.05); the two group after treatment compared with the treatment of various inflammatory factors the decreased IL-2 in the treatment group after treatment 1, 3 and 7 d in 6 (IL-6), interleukin 8 (IL-8) and CRP were lower than the control group, the difference was statistically significant (P0.05); the treatment group after treatment in the 1 and 3 D of tumor necrosis factor alpha (TNF- alpha) lower than that of the control group, and the difference was statistically significant (P0.05). Conclusion continuous blood purification in patients with severe acute pancreatitis is better than basic treatment in improving the activation and efficacy of RAAS and inflammatory factors.
【作者单位】：南阳医学高等专科学校第一附属医院普通外科;南阳医学高等专科学校第一附属医院肿瘤内科;
【分类号】：R459.5
【正文快照】： 重症急性胰腺炎(severe acute pancreatitis,SAP)是临床常见的危急重症,在多种复杂病因的影响下,患者的胰腺发生自我消化,引起局部炎症、感染和坏死,并伴有全身炎症反应、多器官功能损害,常因病情复杂、进展迅速而导致较高的死亡率。在病程进展过程中,细胞因子、炎症因子的异

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