连续性肾脏替代治疗对长期使用免疫抑制剂治疗慢性肾脏疾病合并重症肺炎患者的疗效分析

Effects of continuous renal replacement therapy on the chronic kidney disease complicated with severe pneumonia patients receiving long-term use of immunosuppressive therapy

目的:探讨连续性肾脏替代治疗(CRRT)治疗慢性肾脏疾病患者长期使用免疫抑制剂治疗并发重症肺炎的疗效。方法:回顾性分析同期在本院ICU接受CRRT联合综合治疗(观察组,74例)和仅接受综合治疗(对照组,74例)长期使用免疫抑制剂治疗慢性肾脏疾病并发的重症肺炎患者的疗效。结果:治疗后观察组SaO2、PaO2和PaCO2改善程度明显高于对照组,差异具有统计学意义(P<0.05);白细胞介素-6(IL-6)及白细胞介素-8(IL-8),干扰素(IFN-γ)、肿瘤坏死因子(TNF-α)及C反应蛋白(CRP)水平降低程度明显高于对照组,差异具有统计学意义(P<0.05);观察组救治成功率高于对照组,差异具有统计学意义(P<0.05);ApacheⅡ评分和6分钟步行距离间改善程度高于对照组,差异具有统计学意义(P<0.05)。结论:CRRT治疗能有效提高抗菌药物和内科综合治疗炎症介质清除效果,改善患者治疗后生存状况,降低死亡率,疗效显著。

Objective：To investigate the effects of continuous renal replacement therapy（CRRT）on the chronic kidney disease complicated with severe pneumonia patients receiving long-term use of immunosuppressive therapy.Methods：The effects of two groups that underwent CRRT combined therapy in our hospital ICU analysis（the observation groups,74cases）and those who only received comprehensive treatment（the control groups,74cases）on the chronic kidney disease complicated with severe pneumonia patients receiving long-term use of immunosuppressive therapy were compared.Results：The improvement of SaO2,PaO2 and PaCO2in the observation groups after treatment were significantly higher than that of the control groups（P〈0.05）.The levels of IL-6,IL-8,IFN- γ,TNF- αand CRP in the observation groups were significantly higher than that of the control groups（P〈0.05）.The success rate of treatment in the observation groups was 67.57%,significantly higher than the control groups（45.95%）（P〈0.05）.The improvement degree of Apache II score and 6minute walk distance in the observation groups were significantly higher than the control group（P〈0.05）.Conclusions：CRRT therapy could effectively improve the cleaning effect,survival status of patients and reduce the mortality rate of comprehensive treatment of antibiotics and department of internal medicine after treatment.