连续性血液净化对多器官功能障碍综合征患者血浆TNF-α、IL-6水平的影响

The application and the effect of TNF-α,IL-6 in plasm of continuous blood purification(CBP) in patients with multiple organ disorder syndrome(MODS)

目的探讨连续性血液净化治疗(CBP)在多器官功能障碍综合征(MODS)中的应用及对血浆TNF-αI、L-6浓度的影响。方法应用CBP治疗MODS患者26例,检测患者治疗前后血生化、血常规及血浆TNF-αI、L-6等指标的变化。结果CBP治疗后患者血肌酐和尿素氮等显著下降(P<0.01),电解质紊乱和代谢性酸中毒得到明显纠正(P<0.05),C-反应蛋白(CRP)明显降低(P<0.05),血浆TNF-α、IL-6浓度显著降低(P<0.05、P<0.01)。治疗后26例患者中8例存活,存活率为31%。结论CBP能有效纠正MODS患者水、电解质及酸碱平衡紊乱,消除炎性反应物质,防止脏器损害的进一步发展,改善预后,提高存活率。

Objective To investigate the application and the effect of TNF-α,IL-6 in plasm of continuous blood purification in patients with multiple organ disorder syndrome （MODS）. Methods Twenty-six patients with MODS were treated by CBP. Blood markers of biochemistry, blood routine and TNF-α, IL-6 in plasm were checked before and after treatment. Results Blood levels of Scr,BUN, WBC,CRP, TNF-α, IL-6 after treatment were significandy lower than those before treatment of CBP （ P 〈 0.05, P 〈 0.01 ）, and blood levels of pH and HCO2^- after treatment were significantly higher than those before treatment of CBP（P 〈 0.05, P 〈 0.01 ）. 8 patients survived in the 26 patients and the survival rate was 31% . Conclusion In the patients with MODS,CBP can efficiendy treat the water-electrolyte disturbance,keep the acid-base balance,clear the inflammatory mediator and protect organs injured further,improve the patients＇ condkion and increase the survival rate.