不同血液净化方式对伴急性肾衰的多器官功能障碍疗效的研究

Observation on different blood purification modes for multiple organ dysfunction syndrome patients associated with acute renal failure

目的:观察血液灌流(HP)联合持续性静脉-静脉血液滤过(CVVH)治疗伴急性肾功能衰竭(ARF)的多器官功能障碍综合征(MODS)患者的临床疗效,并探讨其机制。方法:将40例伴ARF的MODS患者随机分为两组,一组单纯以CVVH治疗,另一组以HP+CVVH治疗,比较两组治疗前后APACHEⅡ评分改善、尿素氮、肌酐和TNF-α及IL-6变化情况。结果:两组治疗后,患者临床状况改善;APACHEⅡ评分均下降,联合治疗组下降更明显;尿素氮和肌酐均下降,两组之间无差别;血清TNF-α及IL-6均降低,但联合治疗组明显优于单纯治疗组(P<0.05)。结论:血液灌流联合持续性静脉-静脉血液滤过治疗伴ARF的MODS可有效调节患者炎症因子水平,提高疗效。

Objective：To investigate the efficacy of hemoperfusion（HP） with continuous blood purification（CBP） on patients suffered from multiple organs failure with acute renal failure and its mechanism.Methods：40 patients were divided into two groups randomly,one group received continuous blood purification treatment only,and the other group was received HP with CBP treatment.Comparison of the change of APACHEⅡscore and the level of BUN,Cr,TNF-α and IL-6 before and after treatment was made.Results：After treatment,the clinical symptoms of patients in both two groups were improved,the APACHEⅡscore reduced,as well as the level of BUN and Cr.But there was no significant difference of BUN and Cr in two groups.Furthermore,the levels of TNF-α and IL-6 also declined.The efficacy in the combination treatment group was better than the CBP group（P0.05）.Conclusion：The treatment of HP with CBP is effective in changing the level of inflammatory and improving patient＇s treatment＇s effect.