摘要
目的比较不同置换液量对连续性肾脏替代治疗(CRRT)重症肝炎清除能力及疗效的影响,以期降低患者血TNF-α、IL-6、BUN及Cr的浓度,并改善患者预后。方法选取医院2006年3月-2007年12月就诊的30例重症肝炎合并肝肾综合征患者,随机分为3组,对照组10例采取单纯血浆置换(PE)加内科综合治疗,治疗组20例采用PE后再CRRT,同时加内科综合治疗;治疗组分为A组和B组、各10例,A组CRRT置换液量为20L(35ml/min,8～12h),B组CRRT置换液量常规定为40L(35ml/min,20～24h);测量3组治疗前后血TNF-α、IL-6、BUN及Cr的含量并观察3组患者预后。结果治疗组血TNF-α、IL-6、BUN及Cr的含量较对照组低,差异有统计学意义(P<0.05),治疗A组和B组及3组患者预后差异无统计学意义。结论 CRRT联合PE可以进一步降低血TNF-α、IL-6、BUN及Cr的浓度,置换液量对CRRT的影响不明显。
OBJECTIVE To explore the impact of scavenging capacity and curative effect of different replacement fluid volume on CRRT in treatment of severe hepatitis so as to reduce the concentration of the TNF-α, IL-6 , BUN,and Cr and improve the prognosis. METHODS A total of 30 cases of severe hepatitis patients with hepatorenal syndrome,who were treated in the hospital from Mar 2006 to Dec 2007, were selected and divided into three groups randomly, 10 cases in the control group were treated with pure plasma exchange combined with comprehensive internal medicine, 20 cases in the treatment group were treated with plasma exchange, and then continuous renal replacement therapy and comprehensive internal medicine. The patients in the treatment group were divided into group A and B, with 10 cases in each. The CRRT replacement fluid volume was 20L （35ml/ min,8--12h） in the group A ,and 40L（35ml/min, 20--24h） in the group B. The content of the TNF-α, IL-6, BUN and Cr in blood of three groups of patients was measured, and the prognosis of the three groups of patients was observed. RESULTS The content of TNF-α,IL-6 ,BUN and Cr in the blood was lower in the treatment group than in the control group, the difference was statistically significant （P〈0.05）, there was no statistical difference in the prognosis between the group A and group B as well as between the three groups. CONCLUSION CRRT combined with PE can further reduce the concentration of TNF-α,IL-6,BUN and Cr in blood, and there was no significant effect of the replacement fluid volume on CRRT.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第2期315-317,共3页
Chinese Journal of Nosocomiology
关键词
连续性肾替代治疗
血浆置换
晚期重症肝炎
肝肾综合征
Continuous renal replacement therapy
Plasma replacement
Advanced severe hepatitis
Hepatorenal syndrome
