连续性血液净化治疗慢性肾衰竭合并全身炎性反应综合征的临床分析

A Clinical Research of Continuos Blood Purification on Treatment of Chronic Renal Failure Patients Complicated with Systemic Inflammatory Response Syndrome

目的分析连续性血液净化在慢性肾衰竭合并全身炎性反应综合征中的作用。方法将42例诊断为慢性肾衰竭合并全身炎性反应综合征的患者随机分为观察组和对照组,各21例。观察组患者采用连续性血液净化+内科常规治疗,对照组仅采用内科常规治疗,记录观察组在连续性血液净化治疗前后免疫功能指标的变化情况,并比较两组患者治疗前后血白细胞计数(WBC)、中性粒细胞百分比、中性粒细胞计数、C反应蛋白、尿素氮、肌酐、β2微球蛋白等指标的变化。结果观察组连续性血液净化后CD3+、CD4+较治疗前均明显升高,CD8+较治疗前明显下降(P<0.05);观察组治疗后各临床指标较治疗前均显著下降,对照组WBC较治疗前下降,其余指标无明显变化;与对照组比较,观察组住院天数和病死率明显减少,两组比较差异有统计学意义(P<0.05)。结论采用连续性血液净化对慢性肾衰竭合并全身炎性反应综合征患者进行治疗,临床疗效佳、治疗时间短,值得临床推广应用。

Objective To observe the clinical efficacy of chronic renal failure patients complicated with systemic inflammatory response syndrome.Methods 42 patients who were diagnosed as chronic renal failure complicated with systemic inflammatory response syndrome were divided into two groups,21 cases each.The observation group was given continuous blood purification and routine medical treatments,while the control group was just given medical treatments.The immune function parameters were observed before and after continuous blood purification in the observation group.The clinical parameters including white blood cell count（WBC）,neutrophil percentage,neutrophil cell count,C-reactive protein,urea nitrogen,creatinine and β2-microglobulin,were compared before and after treatment in each group.Results CD3 ＋,CD4 ＋increased,CD8 ＋decreased significantly after continuous blood purification in the observation group（P0.05）.The clinical parameters decreased significantly in the observation group,no change was observed in the control group except WBC,the hospitalization day and mortality of the observation group was shorter（P0.05）.Conclusion Continuous blood purification is effective and can shorten hospitalization day and lower mortality in chronic renal failure patients complicated with systemic inflammatory response syndrome.