| 苏 梅,王海霞,苏晓峰,张 超,祁小宇.连续性血液净化与间歇性血液透析对脓毒症合并急性肾损伤患者RAAS系统指标和血清sTREM-1、HMGB1、TLR4的影响[J].,2024,(17):3265-3268 |
| 连续性血液净化与间歇性血液透析对脓毒症合并急性肾损伤患者RAAS系统指标和血清sTREM-1、HMGB1、TLR4的影响 |
| Effects of Continuous Blood Purification and Intermittent Hemodialysis on RAAS System Indexes and Serum sTREM-1, HMGB1 and TLR4 in Patients with Sepsis Combined with Acute Kidney Injury |
| 投稿时间：2024-03-23 修订日期：2024-04-20 |
| DOI：10.13241/j.cnki.pmb.2024.17.013 |
| 中文关键词: 血液净化 血液透析 脓毒症 急性肾损伤 RAAS系统 sTREM-1 HMGB1 TLR4 |
| 英文关键词: Blood purification Hemodialysis Sepsis Acute kidney injury RAAS system sTREM-1 HMGB1 TLR4 |
| 基金项目:河北省医学科学研究计划项目（20220408） |
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| 中文摘要: |
| 摘要 目的：对比脓毒症合并急性肾损伤（AKI）患者分别经间歇性血液透析（IHD）、连续性血液净化（CBP）治疗后血清肾素-血管紧张素-醛固酮（RAAS）系统指标和血清高迁移率族蛋白1（HMGB1）、可溶性髓系细胞触发受体-1（sTREM-1）、Toll样受体4（TLR4）的变化情况。方法：选取2019年1月~2023年6月期间我院收治的107例脓毒症合并AKI患者。根据随机数字表法将患者分为间歇组（n=53，接受IHD治疗）和连续组（n=54，接受CBP治疗）。对比两组RAAS系统指标、血清sTREM-1、HMGB1、TLR4、肾功能、免疫功能指标。结果：治疗后，两组肾素活性（PRA）、醛固酮（ALD）、血管紧张素Ⅰ（AngI）、sTREM-1、HMGB1、TLR4、尿素氮（BUN）、血肌酐（Scr）下降，且连续组低于间歇组（P<0.05）。治疗后，两组CD8+下降，且连续组低于间歇组；CD3+、CD4+、CD4+/CD8+升高，且连续组高于间歇组（P<0.05）。结论：与IHD治疗相比，CBP治疗脓毒症合并AKI，可进一步改善肾功能，提高免疫功能，调节RAAS系统指标和血清sTREM-1、HMGB1、TLR4水平。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the changes in serum renin angiotensin aldosterone (RAAS) system indicators and serum high mobility group protein 1 (HMGB1), soluble myeloid cell trigger receptor-1 (sTREM-1), and Toll like receptor-4 (TLR4) levels in patients with sepsis complicated by acute kidney injury (AKI) after intermittent hemodialysis (IHD) and continuous blood purification (CBP) treatment. Methods: 107 patients with sepsis combine with AKI admitted to our hospital from January 2019 to June 2023 were selected. Patients were divided into intermittent group (n=53, receiving IHD treatment) and continuous group (n=54, receiving CBP treatment) according to the random number table method. The RAAS system indexes, serum sTREM-1, HMGB1, TLR4, renal function and immune function indexes were compared between two groups. Results: After treatment, the renin activity (PRA), aldosterone (ALD), angiotensin I (AngI), sTREM-1, HMGB1, TLR4, urea nitrogen (BUN) and serum creatinine (Scr) in two groups decreased, and those in continuous group were lower than those in intermittent group (P<0.05). After treatment, CD8+ decreased in both groups, and continuous group was lower than than in intermittent group. CD3+, CD4+, CD4+/CD8+ increased, and continuous group were higher than those in intermittent group (P<0.05). Conclusion: Compared with IHD treatment, CBP treatment of sepsis combine with AKI, which can further improve renal function, improve immune function, regulate RAAS system indexes and serum sTREM-1, HMGB1, TLR4 levels. |
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