连续静脉-静脉血液滤过联合血液灌流对MODS患者胰岛素抵抗的影响

Influence of continuous venous-venous hemofiltration combined with hemoperfusion on the insulin-resistance in patients with MODS

目的探讨连续静脉-静脉血液滤过联合血液灌流对多器官功能障碍综合征(MODS)患者胰岛素抵抗的影响。方法选取2012年1月至2015年2月濮阳市人民医院行血液净化治疗的120例MODS患者,按照入院顺序分为实验组和对照组。对照组行连续静脉-静脉血液滤过治疗,实验组行连续静脉-静脉血液滤过联合血液灌流治疗。观察两组患者生化指标、CRP、IL-6、TNF-α、脏器功能指标变化情况。结果实验组治疗后BMI、Hb、FBG、FIBS、Homa-IR水平低于对照组和治疗前,AIb水平高于对照组和治疗前,差异有统计学意义(P<0.05)。实验组治疗后CRP、IL-6、TNF-α、Cr、CK-MB、PaO——2水平低于治疗前和对照组,差异有统计学意义(P<0.05)。结论连续静脉-静脉血液滤过联合血液灌流对MODS患者胰岛素抵抗有积极效果,临床应用价值较高。

Objective To explore the influence of continuous venous-venous hemofiltration combined with hemoperfusion on the insulin-resistance in patients with MODS.Methods 120 patients with MODS were randomly divided into experiment group and control group.The control group were treated by continuous venous-venous hemofiltration,and the experiment group were treated by continuous venous-venous hemofiltration combined with hemoperfusion.The biochemical indexes,CRP,IL-6, TNF-α,organic function were observed.Results The levels of BMI,Hb,FBG,FIBS,Homa-IR after treatment in the ex-periment group were lower than the control group and before treatment,and the levels of AIb after treatment in the experiment group were lower than the control group and before treatment （P〈0.05）.The levels of CRP,IL-6,TNF-α,Cr,CK-MB, PaO2 in the experiment group after treatment were lower than the control group and before treatment （P 〈0.05 ）. Conclusions Continuous venous-venous hemofiltration combined with hemoperfusion has active effects on the insulin-resist-ance in patients with MODS.It has high values of clinical application.