连续性静-静脉血液滤过治疗对血液中TNF-α、IL-1、IL-6浓度的影响

The change of serum concentrations of TNF -α, IL-1, JL - 6 during continuous veno - venous hemofiltration therapy

目的 探讨连续性静-静脉血液滤过治疗(CVVH)对外周血中肿瘤坏死因子(TNF-α),白介素-1(IL-1),白介素-6(IL-6)浓度的影响。方法 30例肾功能不全患者行CVVH,血滤器采用AV600(聚砜膜,1.4m^2),治疗前、治疗2h、6h、8h、结束时取血和滤波采用ELISA法测定TNF-α、IL-1、IL-6浓度。结果 CVVH过程中血液TNF-α、IL-1、IL-6浓度缓慢降低,于6h达到最低点,与治疗前对比差异显著(P<0.05)。8h后血液中TNF-α、IL-1、IL-6浓度逐渐上升。治疗结束后浓度回升至接近治疗前水平(P>0.05),滤液中始终未检测到上述因子。结论 CVVH使用聚砜膜滤过器时对血中TNF-α、IL-1、IL-6有清除作用,此种作用于CVVH治疗6小时后消失,其消除方式可能是吸附。

Objective To detect serum concentrations of tumor necrotic factor( TNF - a),interleukin - 1 (IL - 1),interleukin- 6 (IL- 6) during continuous veno- venous hemofiltration therapy(CWH) methodology.Methods Thirty patients treated with CWH,AV600 hemofilter (Polysulfone,1.4m2) was used,Blood and ultrafiltran'on fluid was sampled before and 2,6,8 hours in the process of CWH.Results During CWH procedure,TNF-a,IL-1 andIL-6 levels were decreased progressively,got to the lowest at 6 hours,which was significantly lower than 0 hourt,After 8 hours,TNF - a,IL- 1 and IL- 6 levels increase slowly,and none of the three mediators could be detected in the ultra-filtration fluid.Condution Serum TNF- a,IL-landIL-6gottothe nadir at 6 hours in the process of CWH with polysulfone hemofilter and the clearing of these mediators may be mainly through absorption but not filtration.