CRRT对脓毒症患者疗效及炎性因子的影响

Effect of CRRT on the Efficacy and Inflammatory Factors in Patients with Sepsis

目的:探讨和研究连续性肾脏替代治疗(CRRT)对脓毒症患者疗效及炎性因子的影响,为临床提供必要依据。方法:选取2011年1月-2014年10月本院收治的100例脓毒症患者作为研究对象,根据治疗方案的不同按照随机数字表法将其分为对照组和观察组,每组50例。对照组采取常规治疗,观察组则在常规治疗的基础上进行CRRT治疗,评价并对比两组患者治疗后的疗效情况,并用酶联免疫吸附试验进行血清白细胞介素-1β(IL-1β)、血清白细胞介素-6(IL-6)、C反应蛋白(CRP)的检验,对比两组患者的各项实验数据。结果:经治疗后,观察组的治疗总有效率94.0%(47/50)明显高于对照组的78.0%(39/50),比较差异有统计学意义(字2=5.3156,P=0.0211)。两组患者治疗前的IL-1β、IL-6、CRP水平比较差异均无统计学意义(P>0.05)。观察组治疗后的IL-1β、IL-6、CRP分别为(19.4±3.6)ng/L、(59.4±18.9)ng/L、(21.9±6.9)mg/L,均明显低于对照组的(41.7±11.6)ng/L、(99.6±22.4)ng/L、(35.7±6.1)mg/L,差异均有统计学意义(P<0.05)。结论:CRRT用于脓毒症患者的治疗,在改善患者炎症反应、加速炎症介质清除方面有突出优势,但在治疗剂量方面应当进行合理选择,在确保能够有效降低血清炎性因子水平的基础上,减少治疗并发症的发生。总体而言,CRRT治疗脓毒症的疗效确切,值得在临床上推广和应用。

Objective： To investigate and study the effect of continuous renal replacement therapy （ CRRT ） on the curative effect and inflammatory factors in patients with sepsis, to provide the necessary basis for clinical.Method： 100 patients with sepsis admitted to our hospital from January 2011 to October 2014 were selected as research objects, according to the different treatment options, they were divided into the control group and the observation group by random number table method, 50 cases in each group.The control group was given conventional therapy, the observation group was given CRRT treatment on the basis of conventional therapy, the efficacy of the two groups after treatment were evaluated and compared, and the serum interleukin -113 （ IL-1 [3 ）, the serum levels of interleukin-6 （ IL-6 ）, C reactive protein （ CRP ）were tested by enzyme linked immunosorbent assay, the exlerimental data were compared between the two groups.Result： After treatment, the total effective rate of the observation group was 94.0% （ 47/50 ）, which was significantly higher than 78.0% （ 39/50 ） of the control group, the difference was statistically significant （ X2=5.3156, P=0.0211 ） .There were no statistically significant differences in the IL-1β , IL-6, CRP levels of the two groups before treatment （ P〉0.05 ） .The IL-1β , IL-6, CRP levels of the observation group after treatment were （ 19.4 ± 3.6 ） ng/L, （ 59.4 _± 18.9 ） ng/L, （ 21.9 ± 6.9 ） mg/L, which were significantly lower than （ 41.7 ± 11.6 ） ng/L, （ 99.6 ± 22.4 ） rig/L, （ 35.7 ± 6.1 ） mg/L of the control group, the differences were statistically significant （P〈0.05） .Conclusion： CRRT for the treatment of patients with sepsis, have outstanding advantages in the improvement of patients with inflammatory reaction, accelerate the elimination of inflammatory mediators.But in the aspect of treatment dose should carry out reasonable choice, on the basis of ensuring that the level of serum inflammatory factors can be effectively reduced, reduce the incidence of complications.Overall, the efficacy of CRRT in the treatment of sepsis is accurate, is worthy of clinical popularization and application.