连续性血液净化治疗对全身炎症反应综合征及脓毒血症患者一氧化氮合酶和降钙素原的影响

Effect of CRRT on nitric oxide synthase and procalcitonin in systemic inflammatory response syndrome and sepsis patients

目的:研究连续性血液净化(CRRT)对治疗全身炎症反应综合征(SIRS)及脓毒血症(Sepsis)的临床疗效及对患者一氧化氮合酶(NOS)和降钙素原(PCT)的影响,为CRRT和SIRS治疗提供新思路。方法:收集收住本院急诊ICU、内科ICU及外科ICU的SIRS及Sepsis患者病例,记录在血液净化治疗前及治疗后24、48、72h的生命体征、氧合指数(PaO2/FiO2)、血生化、血常规、血气分析、APACHE II评分的变化,并采用比色法检测患者血清NOS含量变化,采用免疫发光法检测患者血清PCT含量变化。结果:CRRT治疗后24、48、72h血生化及血常规指标均有显著改善,各时间点NOS值及PCT值较治疗前均显著降低,差异具有统计学意义(P<0.05)。结论:CRRT治疗能显著改善SIRS/Sepsis患者的临床症状,其治疗作用与清除损伤性作用因子NOS及PCT相关。

AIM： The purpose of this study is to evaluate the efficacy of the Continuous Renal Replacement Therapy （CRRT） on systemic in- flammatory response syndrome （SIRS） and Sep- sis and the influence on nitric oxide synthase （NOS） and procalcitonin （PCT）, to provide new ideas on the CRRT of SIRS. METHODS： We collected the SIRS and Sepsis cases in Depart- ment of emergency ICU, internal medicine ICU and surgical ICU of our hospital, recorded chan- ges （before CRRT, 12, 48, 72 h purification treatment）, in vital signs, oxygenation index （PaO2/FiO2）, blood biochemistry, blood rou- tine, blood gas analysis and APACHE II score. NOS was detected by colorimetric method, andPCT was detected by immune chemilumines- cence method. RESULTS.After 24, 48, 72 h of CRRT treatment, blood biochemical and blood indexes were significantly improved, and the values of NOS and PCT were all significantly lower than the values of treatment before. The difference was statistically significant （P〈0.05）. CONCLUSION. CRRT can improve the clinical symptoms of patients with SIRS/Sepsis by removing the damage factor of NOS and PCT.