持续血液净化疗法治疗外伤继发性脓毒症临床效果及对高迁移率族蛋白1、肿瘤坏死因子-α和促血管生成素2的影响

Clinical effects of continuous blood purification therapy in treatment of traumatic sepsis and its influence on high mobility group protein-1, tumor necrosis factor-α and angiopoietin-2

目的探讨持续血液净化疗法治疗外伤继发性脓毒症临床效果及高迁移率族蛋白1(HMG-1)、肿瘤坏死因子-α(TNF-α)和促血管生成素2(Ang-2)的影响。方法选取外伤继发性脓毒症90例,以随机数字表法分为对照组(45例)和试验组(45例);其中对照组患者采用常规对症支持治疗,试验组患者则在对照组治疗基础上加用持续血液净化疗法;比较两组患者临床疗效,28 d内死亡率,治疗前后APACHE II评分和HMG-1、TNF-α及Ang-2等炎症因子水平。结果试验组患者临床疗效显著优于对照组,差异有统计学意义(P<0.05);试验组患者28 d内死亡率显著低于对照组,差异有统计学意义(P<0.05);两组患者治疗后APACHEII评分和炎症因子水平显著低于治疗前,且试验组患者治疗后各项指标水平低于对照组,差异有统计学意义(P<0.05)。结论持续血液净化疗法治疗外伤继发性脓毒症可有效缓解临床症状,降低病死率和炎症因子水平,对于改善预后具有重要意义。

【Objective】To investigate clinical effects of continuous blood purification therapy in treatment of traumatic sepsis and its influence on HMG-1, TNF- α and Ang-2. 【Methods】90 patients with traumatic sepsis were randomly divided into two groups ： control group（45 patients） with conventional symptomatic treatment and experiment group（45 patients） with continuous blood purification therapy on the basis of control group; and the clinical efficacy,mortality in 28 d, APACHE II score and levels of inflammatory factor including HMG-1,TNF- α and Ang-2 before and after treatment of both groups were compared.【Results】The clinical efficacy of experiment group was significant better than control group（P〈0.05）. The mortality in 28 d of experiment group was significant lower than control group（P〈0.05）. The APACHE II score and levels of inflammatory factor after treatment of both groups was significant better than before treatment（P〈0.05）. The indexes above after treatment of experiment group was significant better than control group（P〈0.05）.【Conclusion】Continuous blood purification therapy in treatment of traumatic sepsis can efficiently relieve clinical symptoms, reduce the mortality risk and level of inflammatory factors with important significance for improving prognosis.