连续性肾脏替代治疗联合血液灌流治疗毒蕈所致多器官功能衰竭

Effects of Continuous Renal Replacement Therapy Combined Hemoperfusion for Multiple Organ Dysfunction Syndrome Induced by Mushroom Poisoning

目的:探讨连续性肾脏替代治疗(continuous renal replacement therapy,CRRT)联合血液灌流治疗(he-moperfusion,HP)毒蕈中毒所致的多器官功能衰竭(multiple organ dysfunction syndrome,MODS)的疗效。方法:选择30例毒蕈中毒所致多器官功能衰竭患者,随机分为联合组及HP组(n=15),均行常规及HP治疗,HP治疗2 h后,联合组再行CRRT治疗24 h。治疗14 d后,测定患者炎性因子、心肌酶及肝肾功能指标。结果:治疗14 d后,两组患者AST、ALT、LDH、心肌酶(creatine kinase-MB,CK-MB)、血清肌酐(serum creatinine,SC)、IL-6及C反应蛋白(C-reactive protein,CRP)较治疗前均降低,差异有统计学意义(P<0.05)。与HP组比较,联合组患者肝肾功能及心肌酶指标均好转,病死率下降,差异有统计学意义(P均<0.05)。结论:CRRT联合HP治疗可通过调节炎性因子C反应蛋白、IL-6等表达水平来改善MODS症状,降低病死率。

Objective To investigate the therapeutic effects of CRRT combined HP in treatment of MODS induced by mushroom poisoning.Methods Thirty patients with MODS induced by mushroom poisoning were selected and randomly divided into combined group and HP group,all patients received routine and HP treatment.After treating with HP for 2 h,the patients in combined group received CRRT treatment for 24 h.The inflamatory,cardiac enzyme(CK-MB),parameters of liver and kindey functions were determined after treating for 14 d.Results The levels of ALT,AST,LDH,CK-MB,Scr,IL-6 and CRP were significantly decreased after treatment(P < 0.05).Compared with HP group,the liver and kidney function,CKMB were all improved in combined group,the fatality rate was significantly decreased(all P < 0.05).Conclusion CRRT combined HP can improve the prognosis of MODS induced by mushroom poisoning through regulating the levels of inflamation,such as CRP and IL-6.