早期血液灌流对急性重症胰腺炎治疗的探索

Effect of early hemoperfusion on severe acute pancreatitis

目的通过检测急性重症胰腺炎(SAP)患者血清IL-18、TNF-α及IL-10的变化,探讨早期血液灌流(hemoperfusion)的治疗效果。方法 20例患者采取血液灌流治疗(血液灌流组),同期22例患者未行血液灌流治疗(常规治疗组)。测定和比较治疗后第1、3、7天血清白介素18(IL-18)、肿瘤坏死因子(TNF-α)和白介素10(IL-10)的水平。结果两组IL-18、TNF-α、IL-10比较有统计学差异(P<0.05);血液灌流组住院天数比常规治疗组明显缩短(P<0.05)。血液灌流组死亡2例,常规治疗组死亡5例。结论血液灌流能有效清除SAP患者的血清IL-18和TNF-α,促进IL-10生成,提高早期抢救成功率,缩短住院天数。

【Objective】 To explore the effect of early hemoperfusion on patients with severe acute pancreatitis through the variation of serum cytokines.【Methods】 Serum IL-18,IL-10 and TNF-α levels were determined on day 1,3,and 7 after-therapy in the hemoperfusion group（20 cases） and the non-hemoperfusion group（22 cases）.【Results】 In the hemoperfusion group,serum IL-18 and TNF-α were significantly lower than those in the non-hemoperfusion group on day 1,3,and 7 after-therapy（P〈0.05）,while IL-10 was significantly higher than that in the non-hemoperfusion group on day 3 and 7 after-therapy（P〈0.05）.Compared to the non-hemoperfusion group,the in-hospital duration was shorter（P〈0.05）,and the death rate was lower in the hemoperfusion group.【Conclusions】 Hemoperfusion can eliminate serum IL-18 and TNF-α,promote the formation of IL-10,thus block inflammation reaction.It may become an important therapeutic method for severe acute pancreatitis.