连续性血液净化对MODS合并ARF患者炎性因子和凝血功能的影响

Study on influence of continuous blood purification on inflammatory factors and blood coagulation function in patients with MODS complicated with ARF

目的探讨连续性血液净化对多器官功能障碍综合征(MODS)合并急性肾功能衰竭(ARF)患者炎性因子和凝血功能的影响。方法对2011年2月至2012年11月收治的89例MODS合并ARF的患者的临床资料进行回顾性分析,观察患者的炎症因子和凝血功能的变化。结果 89例患者治疗后12 h、24 h K+、尿素氮(BUN)、肌酐(Cr)、心率(HR)的水平明显低于治疗前(0 h),差异有统计学意义(P<0.05);而Na+、葡萄糖(Glu)及平均动脉压(MAP)治疗前后无明显变化,差异无统计学意义(P>0.05);治疗后12 h、24 h白介素6(IL-6)、白介素10(IL-10)、肿瘤坏死因子α(TNF-α)的水平明显优于治疗前(0 h),差异有统计学意义(P<0.05);治疗后12 h、24 h纤溶酶原活化抑制物(PAI-1)、C反应蛋白(CRP)的水平明显优于治疗前(0 h),差异有统计学意义(P<0.05)。结论 MODS合并ARF患者给予连续性血液净化治疗,可改善患者的血纤溶紊乱,稳定血流动力学,清除血液中的炎症因子。

Objective To explore the influence of continuous blood purification on inflammatory factors and blood coagulation function in patients with multiple organ dysfunction syndrome（MODS） complicated with acute renal failure（ARF）.Methods The clinical data of 89 hospitalized patients with MODS complicated with ARF during February 2011 to November 2012 were retrospectively analyzed,the changes in inflammatory factors and blood coagulation function were detected.Results Blood levels of K ＋,BUN and Cr and HR in 89 patients after treatment for12 h and 24 h were significantly lower than those before treatment（0 h）（P 0.05）.Blood levels of Na ＋,Glu and MAP had no obvious change before and after treatment,the difference was not statistically significant（P 0.05）.The blood levels of IL-6,IL-10 and TNF-α after treatment for 12 h and 24 h were better than those before treatment（0 h）（P 0.05）.Blood levels of PAI-1 and CRP after treatment for12 h and 24 h were better than those before treatment（0 h）（P 0.05）.Conclusion The application of continuous blood purification in patients with MODS complicated with ARF can improve their blood fibrinolytic disorder,keep stable hemodynamics and clearance of inflammatory factors in blood.