连续性血液净化对重症急性胰腺炎患者肾素-血管紧张素-醛固酮系统及炎性指标的影响

Influence of Continuous Blood Purification on RAAS and Inflammatory Markers in Patients with Severe Acute Pancreatitis

目的探讨连续性血液净化对重症急性胰腺炎患者血清肾素-血管紧张素-醛固酮(RAAS)系统及炎性指标的影响。方法选取2010年6月—2013年2月于河南省人民医院接受常规治疗的26例重症急性胰腺炎患者为对照组,同时期接受常规治疗加连续性血液净化治疗的26例患者为观察组,对比分析两组患者治疗前与治疗后1、3d时血清RAAS系统指标〔血管紧张素Ⅰ(Ang-Ⅰ)、血管紧张素Ⅱ(Ang-Ⅱ)、肾素、醛固酮〕及炎性指标〔肿瘤坏死因子α(TNF-α)、白介素(IL)-1β、IL-6和IL-8〕的变化。结果治疗前两组患者血清RAAS系统指标及炎性指标比较,差异均无统计学意义(P>0.05)。治疗后1、3 d时观察组Ang-Ⅰ、Ang-Ⅱ、肾素、醛固酮及TNF-α、IL-1β、IL-6和IL-8水平均低于对照组,差异有统计学意义(P<0.05)。结论连续性血液净化对重症急性胰腺炎患者血清RAAS系统指标及炎性指标的影响较为明显,可有效改善上述指标。

Objective To study the influence of continuous blood purification on rennin-angiotensin-aldosterone system（RAAS） and inflammatory markers in patients with severe acute pancreatitis（SAP）.Methods Twenty-six SAP patients given conventional treatment from June 2010 to February 2013 in He′nan Province People′s Hospital were enrolled as control group,26 patients receiving conventional treatment and continuous blood purification as study group.The changes of serum Ang-Ⅰ,Ang-Ⅱ,renin,aldosterone and TNF-α,IL-1β,IL-6,IL-8 were analyzed comparatively before treatment and on days 1,3 after treatment.Results There was no significant difference in serum RAAS and inflammatory markers between 2 groups before treatment（P＞0.05）.Angiotensin-I,-II,rennin,aldosterone,tumor necrosis factor-alpha,IL-1β,IL-6,IL-8 were lower in study group than in control group on days 1,3 after treatment,the difference was significant（P＜0.05）.Conclusion Continuous blood purification is obviously effective on serum RAAS and inflammatory markers in SAP patients,which can improve the above indexes effectively.