持续血液净化治疗对重症胰腺炎合并MODS患者炎症反应状态及靶器官损伤的影响

Influence of continuous blood purification on inflammation and target organ damage in patients with severe acute pancreatitis complicated by MODS

目的:探讨持续血液净化治疗对重症胰腺炎合并MODS患者炎症反应状态及靶器官损伤的影响。方法:收集本院收治的重症胰腺炎合并MODS患者78例,按照随机数表法分为对照组、观察组各39例。对照组患者接受常规治疗,观察组患者在常规治疗基础上加入持续血液净化治疗,对比两组治疗前后的血清炎症因子、肝功能指标、肾功能指标的差异。结果:治疗前,两组血清中炎症因子、肝功能指标、肾功能指标含量的差异无统计学意义(P>0.05)。治疗后,观察组血清中炎症因子IL-6、IL-8、MCP-1、HMGB1的含量低于对照组,肝功能指标ALT、AST、TBIL、ALP的含量低于对照组,肾功能指标Scr、BUN的含量低于对照组(P<0.05)。结论:持续血液净化治疗可减轻重症胰腺炎合并MODS患者的全身炎症反应,减轻肝肾功能损伤。

Objective：To study the influence of continuous blood purification on inflammation and target organ damage in patients with severe acute pancreatitis accompanied by MODS.Methods：78patients with severe acute pancreatitis complicated by MODS who were treated in our hospital between June 2012 and March 2016 were selected and divided into control group（n=39）and observation group（n=39）according to random number table.Control group were treated with routine treatment,observation group were treated with conventional treatment plus continuous blood purification,and serum inflammatory factors,liver function indexes and renal function indexes were compared between two groups of patients before and after treatment.Results：Before treatment,differences in serum levels of inflammatory factors,liver function indexes and renal function indexes were not statistically significant between two groups of patients（P〈0.05）.After treatment,serum inflammatory factors IL-6,IL-8,MCP-1and HMGB1 levels of observation group were lower than those of control group,liver function indexes ALT,AST,TBIL and ALP levels of observation group were lower than those of control group,and renal function indexes Scr and BUN levels of observation group were lower than those of control group（P〈0.05）.Conclusion：Continuous blood purification can reduce the systemic inflammatory response as well as liver and kidney injury in patients with severe acute pancreatitis