连续性血液净化对急性呼吸窘迫综合征患者血浆细胞因子的影响

Effect of CBP Therapy on the Plasma Cytokine in Patients with Acute Respiratory Distress Syndrome

目的:探讨连续性血液净化(CBP)对急性呼吸窘迫综合征(ARDS)患者血浆细胞因子的影响。方法:对32例急性呼吸窘迫综合征患者进行CBP治疗,使用ELISA法检测治疗前和治疗后1、2、3、6、12h和停止治疗后12h血浆中TNF-α、IL-1β、IL-6、IL-8的浓度,并与同期健康人群做比较。结果:ARDS患者血浆TNF-α、IL-1β、IL-6、IL-8浓度显著高于健康人群,CBP治疗后四种细胞因子逐渐下降,第6h降至最低,停止治疗后12h有不同程度的回升,但仍低于治疗前水平。结论:ARDS患者血浆中细胞因子明显增高。CBP可有效清除ARDS患者血浆中细胞因子,从而阻断全身炎症反应。

Objective: To explore the effect of continuous blood purification(CBP) on the plasma cytokine in patients with acute respiratory distress syndrome(ARDS). Methods: 32 patients with ARDS were treated by CBP. 4 plasma cytokine including TNF-α、IL-1β、IL-6、IL-8 were detected by ELISA at 0,2,4,6,8,10,12 hour following CBP and 12 hours post CBP. Result: TNF-α、IL-1β、IL-6、IL-8 levels were markedly higher than control group. The cytokines started to reduce at 2 hours and decreased to lowest levels at 6 hours after CBP(P < 0.001) and slightly elevated at 12 hours postCBP but still lower than the levels before CRRT. The life signs of all subjects were smooth during CBP. The concentrations of these four cytokines were higher in these patients at all time points than those in the normal people. Conclution: CBP can effectively clear the inflammatory cytokines therefore block inflammatory pathogenesis in ARDS.