高容量连续性血液净化(CBP)治疗脓毒血症并急性肾损伤的临床疗效

The treatment of high-capacity continuous blood purification(CBP) for sepsis and acute kidney injury in clinical efficacy,inflammatory cytokines and renal function

目的研究脓毒血症合并急性肾损伤者行高容量连续性血液净化(CBP)治疗对临床疗效、炎症因子及肾功能的影响。方法对2014年2月-2016年6月本院已确诊脓毒血症并急性肾损伤120例患者资料进行分析,依据CBP治疗时选择的不同容量分成对照组及观察组,两组均为60例,对前者实施标准容量CBP治疗,对后者实施高容量CBP治疗,观察与比较两组临床疗效、炎症因子及肾功能情况。结果观察组治疗后SOFA与APACHEⅡ评分(3.08±1.40)分与(38.50±4.14)分均比对照组(7.30±2.58)分与(50.80±5.58)分低,比较差异具有统计学意义(P<0.05);观察组于两组治疗12h TNF-α、IL-6水平和治疗后BUN、SCr水平均改善基础上,其改善幅度更具有统计学意义(P<0.05)。结论脓毒血症并急性肾损伤者行高容量CBP治疗效果满意,可减少相关器官功能的衰竭,改善患者健康状况,且优化患者炎症因子水平和改善肾功能,具临床推广价值。

Objective To study the patients with acute kidney injury and sepsis underwent high-capacity continuous blood purification （CBP） treatment on clinical efficacy,inflammatory cytokines and renal function.Methods 120 patients with sepsis and acute kidney injury were analyzed in our hospital from February 2014-June 2016,according to by the treatment of CBP different capacity divided into study group and the control group,both groups was 60 cases,the former given the standard capacity CBP treatment,and the latter given high capacity CBP treatment,then observation and comparison of clinical efficacy,and renal function in case of inflammatory cytokines.Results After treatment,The SOFA （3.08 ± 1.40 points） and APACHEⅡ（38.50 ± 4.14 points） score of study group was lower than the control group SOFA （7.30 ± 2.58） points and APACHE Ⅱ （50.80 ± 5.58 points）,the difference was significant statistically significant （P〈0.05）;The study group in both groups healed 12hTNF-α,IL-6 levels after treatment and BUN,SCr levels were improved,based on the magnitude of its more significant improvement （P〈0.05）.Conclusion The patients with sepsis and acute kidney injury by the treatment of high-capacity CBP were satisfactory,could reduce the associated organ failure,improve patient health,and optimized levels of inflammatory cytokines and improve renal function in patients,which has a great clinical value.