连续性血液净化治疗对代偿性抗炎反应综合征的临床研究

发布时间：2018-06-18 15:22

本文选题：连续性血液净化 + 代偿性抗炎反应综合征　；参考：《中国实用内科杂志》2016年09期

【摘要】：目的探讨连续性血液净化治疗(CBP)对代偿性抗炎反应综合征(CARS)的疗效。方法收集2012年5月至2015年12月解放军第202医院血液透析中心、重症监护病房(ICU)由于各种原因致全身炎症反应综合征(SIRS)的患者30例,所有患者均行CBP治疗60 h。采用股静脉临时血液透析留置导管,采用FRESENIUS CBP治疗机;选用AV-600滤器,面积为2.0 m~2进行前稀释连续性静脉-静脉血液滤过(CVVH)。在治疗0 h、6 h、12 h、24 h、48 h、60 h分别采血检测IL-4、IL-10等抗炎性介质及干扰素-γ(IFN-γ)浓度。结果 CBP治疗后外周血单核细胞分泌IL-4、IL-10表达均上升(P0.05),IFN-γ浓度略下降。而血WBC由治疗前的明显升高降至接近正常(P0.05)。结论 CBP治疗不仅能清除炎症介质,同时使抗炎症介质表达增加,Th1/Th2细胞因子表达变化有利于恢复患者免疫细胞功能。
[Abstract]:Objective to investigate the effect of continuous blood purification therapy (CBP) on compensatory anti-inflammatory response syndrome (CARSs). Methods from May 2012 to December 2015, 30 patients with systemic inflammatory response syndrome (SIRS) were treated with CBP for 60 hours. The femoral vein temporary hemodialysis indwelling catheter was used, the FRESENIUS CBP machine was used, the AV-600 filter was used, the area was 2.0 mm2 for continuous venous hemofiltration (CVVH) before dilution. The concentration of anti-inflammatory mediators such as IL-4 and IL-10 and IFN- 纬 of interferon- 纬 were measured at 0 h, 6 h, 12 h, 24 h, 48 h and 60 h. Results after CBP treatment, the expression of IL-4 and IL-10 in peripheral blood mononuclear cells increased and the concentration of IFN- 纬 decreased slightly. However, blood WBC decreased from a significant increase before treatment to close to the normal level (P 0.05). Conclusion CBP can not only remove inflammatory mediators, but also increase the expression of Th1 / Th2 cytokines.
【作者单位】：解放军第202医院血液净化科;
【基金】：辽宁省科技厅医药卫生科研攻关课题(2012020-120-212)
【分类号】：R459.7

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