文章摘要
张怡 宗媛 牛丹 王艳 尹贻明.NMRC-DHP联合CVVH治疗脓毒症并发急性肾功能损伤的疗效观察[J].,2016,16(23):4462-4464
NMRC-DHP联合CVVH治疗脓毒症并发急性肾功能损伤的疗效观察
Clinical Efficacy of NMRC-DHP Combined with CVVH in the Treatment of Sepsis Complicated by Acute Renal Injury
  
DOI:
中文关键词: 脓毒症  急性肾损伤  中性大孔径树脂血液灌流  连续性静脉-静脉滤过
英文关键词: Sepsis  Acute kidney injury  NMRC-DHP  CVVH
基金项目:陕西省自然科学基金面上项目(2014JM4129)
作者单位
张怡 宗媛 牛丹 王艳 尹贻明 陕西省人民医院重症医学科 
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中文摘要:
      目的:探讨中性大孔径树脂血液灌流联合连续性静脉-静脉滤过治疗脓毒症并发急性肾功能损伤的临床疗效。方法:120 名 脓毒症并发急性肾功能损伤的患者随机分成两组,每组60 例。观察组采用中性大孔径树脂血液灌流联合连续性静脉- 静脉滤过 (NMRC-DHP+CVVH)治疗;对照组采用连续性静脉- 静脉滤过(CVVH)治疗。使用ELISA 方法对两组患者CRP、TNF-琢、IL-6 及 IL-10水平进行检测,并对两组APACHEⅡ评分进行比较。结果:①治疗后3 d、7 d、14 d,两组CRP、TNF-琢和IL-6 较治疗前显著 下降,P<0.05,而IL-10 水平差异无统计学意义(P>0.05);同期比较,观察组CRP、TNF-琢和IL-6 水平均低于对照组,P<0.05,而 IL-10 水平无显著变化(P>0.05);②治疗后3 d、7 d、14 d,两组APACHE II 评分较治疗前显著下降,P<0.05;同期比较,观察组APACHEII 评分均低于对照组,P<0.05。结论:相对于单独采用CVVH,采用NMRC-DHP 联合CVVH 治疗脓毒症并发AKI能够更 加有效清除炎症介质,促进肾功能的恢复,疗效确切,值得临床推广。
英文摘要:
      Objective:To evaluate the clinical efficacy of NMRC-DHP combined with CVVH in the treatment of sepsis complicated by acute renal injury.Methods:120 patients with sepsis complicated by acute renal injury were randomly divided into two groups, 60 cases in each group. The patients were treated with NMRC- DHP+ CVVH for the observation group, and the patients were treated with CVVH as a control group. Then the level of CRP, TNF-α, IL-6 and IL-10 were examined using ELISA, and APACHEⅡ of two groups were compared.Results:①At 3 d, 7 d, 14 d after treatment, the level of IL-6, TNF-琢and CRP was significantly decreased in two groups, P<0.05, but there was no significant difference in IL- 10 level; and the level of IL- 6, TNF-琢and CRP in the observation group were lower than that in the control group at the same time, P<0.05, no significant difference was detected in IL-10 level; ②At 3 d, 7 d, 14 d after treatment, APACHE II score of two groups were significantly decreased than before treatment, P<0.05; and it was lower in observation group than that of the control group at the same time, P<0.05.Conclusion:Compared with the single CVVH, NMRC-DHP combined with CVVH in treatment of septic AKI can more effectively remove inflammatory mediators and promote recovery of renal function with exact curative effect, worthy of clinical promotion.
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