连续性血液净化对重症急性胰腺炎血浆炎症介质的影响

Effect of continuous blood purification on the plasma inflammatory mediators in patients with severe acute pancreatitis

目的探讨连续性血液净化(CBP)对重症急性胰腺炎(SAP)患者血浆炎症介质的影响。方法对36例重症急性胰腺炎患者进行CBP治疗,使用ELISA法检测治疗前和治疗后24h、48h血浆TNF-α、IL-1β、IL-6、IL-8的浓度,并与同期健康人群做比较。结果 31例患者好转出院,存活率为86.1%,血生化指标明显改善;SAP患者血浆TNF-α、IL-1β、IL-6、IL-8浓度显著高于正常对照组,CBP治疗24h后四种细胞因子明显低于治疗前水平(P<0.05),治疗48h后有不同程度的回升,但仍低于治疗前水平(P<0.05)。结论 CBP可有效清除SAP患者血浆炎症介质,从而阻断全身炎症反应,改善预后。

Objective To explore the effect of continuous blood purification.（CBP）.for eliminating plasma inflammatory mediators in patients with severe acute pancreatitis（SAP）.Methods Thirty-six patients with SAP were treated by CBP..Four plasma cytokines including TNF-α,.IL-1β,.IL-6,.IL-8 were detected by ELISA at 0,.24,.48 hours after CBP.Results The levels of TNF-α,.IL-1β,.IL-6,IL-8 were significantly higher than that of control group..Thirty-one of all patients got rehabilitation after CBP with a high survival rate.（86.1%）.and significant improvement of serum biochemical indexes..The plasma level of cytokines declined at 24 hours after CBP.（P 0.05）.and these indexes had rebound in different degree at 48 hours after CBP but were still lower than that before CBP..Conclusion CBP effectively clears the plasma inflammatory mediators,.therefore blocks systemic inflammatory response and improves the prognosis of SAP.