连续性血液净化治疗多器官功能衰竭与Th1/Th2失衡的临床研究

Clinic study of effects of continuous blood purification on MODS with Th 1/Th2 inbalance

目的 研究连续性血液净化治疗 (CBP)对多器官功能衰竭患者Th1/Th2失衡的影响。方法2 8例多器官功能障碍综合征 (MODS)患者行CBP治疗。采用中心静脉留置单针双腔导管建立血管通路 ,采用Prisma连续性血液净化系统、以及配套的M6 0管路和血滤器AN6 9(PAN膜 ,2 .0cm2 )进行前稀释连续性静脉 -静脉血液透析滤过 (CVVHDF)。治疗前及治疗后 2 4h ,4 8h ,72h采血检测Th1/Th2。结果 2 2例患者肾功能均恢复正常。在CBP治疗开始后 2 4h血Th1/Th2比值逐渐上升 ,4 8h下降有显著差异 ,72h接近正常。 2 4h与开始前比较 ,72h与 2 4h比较有统计学差异 (P <0 .0 1)。结论 CBP治疗可能可平衡Th1/Th2。

Objective To study the effects of continuous blood purification on patients with MODS and Th1/Th2 inbalance. Methods Twenty-eight patients with multiple organ dysfunction sy ndrome (MODS) were treated with continuous blood purification(CBP), the vascular access es tablished with two-lumen indwelling catheter in vena profundae or internal arte riovenous fistula, Prisma(Hospal)system for continuous venovenous hemodiafiltr ation(CVVHDF), the Gambro AN69 dialyzers with polyacrylonitrile(PAN) membrane we re used. The Th1/Th2 cytokines in plasma were checked before and 24h、48h、72h a fter CBP. Results The renal function of 22 patients recovered. The plasma Th1/Th2 cytokines increased progressively after CBP 24h,nearly normal at 72h and after 48h there was significant difference compared with that before CBP(P<0.01 ). Conclusion blood purification(CBP) may correct the inbalance o f Th1/Th2