摘要
目的 探讨连续性血液净化对重症脓毒症患者炎症和营养状况的影响.方法 选取佛山市第二人民医院2010年7月～2013年7月收治的重症脓毒症患者42例,将其分为对照组和研究组,对照组采用常规治疗,研究组在此基础上行连续性血液净化（CBP）治疗,比较两组患者临床转归、治疗前后APACHE-Ⅱ评分、炎症指标及各项营养指标的变化.结果 与对照组进行比较,研究组患者ICU住院时间更短,病死率及多器官功能障碍综合征（MODS）发生率更低;研究组APACHE-Ⅱ评分改善情况明显优于对照组;治疗2周后研究组患者肿瘤坏死因子α（TNF-α）水平下降为（0.36±0.04）ng/dL,C反应蛋白（CRP）下降为（7.59±4.21）mg/L,对照组TNF-α水平上升为（1.12±0.10）ng/dL,CRP水平下降为（12.01±5.61） mg/L;研究组前白蛋白上升为（134.68±21.98）mg/L,胰岛素样生长因子1 （IGF-1）上升为（2.46±0.36）μg/L;对照组前白蛋白下降为（103.25±12.36）mg/L,IGF-1下降为（1.3 l±0.2）μg/L,两组各指标比较差异均有统计学意义（均P＜ 0.05）.结论 CBP可更好地缓解重症脓毒症患者炎症反应,改善患者营养状况.
Objective To investigate the effect of continuous blood purification on inflammatory and nutritional status in patients with sepsis.Methods 42 patients with severe sepsis of the Second People＇s Hospital of Foshan City from July 2010 to July 2013 were divided into study group and control group,the control group was given conventional ther apy,study group was increased CBP,the clinical outcome of APACHE-Ⅱ score,inflammatory index and the nutritional index between the two groups before and after treatment were compared.Results Compared with control group,the patients in study group had shorter hospital stay in ICU and lower mortality and the incidence rate of MODS; APACHE-]] score in research group was significantly higher than control group; after 2 weeks of treatment,TNF-α level of study group decreased to （0.36±0.04） ng/dL,CRP decreased to （7.59±4.21） mg/L,in control group,TNF-α level increased to （1.12±0.10） ng/dL,CRP decreased to （12.01±5.61） mg/L; the pre-albumin of study group increased to （134.68±21.98） mg/L,IGF-1 increased to （2.46±0.36） μg/L; the pre-albumin of control group decreased to （103.25± 12.36） mg/L,IGF-1 decreased to （1.31±0.2） μg/L,each index of the study group was significantly better than the control group （P 〈 0.05）.Conclusion CBP can effectively relieve patients with severe sepsis inflammatory reaction,improve the nutritional status of the patients.
出处
《中国医药导报》
CAS
2014年第2期57-59,62,共4页
China Medical Herald
基金
广东省第五批科技计划项目(编号2011-06)
关键词
连续性血液净化
脓毒症
营养状况
Continuous blood purification
Sepsis
Nutritional status
