CVVH技术对大肠埃希菌感染脓毒血症患者的血清细胞色素C与sFas及相关血清因子的影响

Effect of CVVH on serum cytochrome C,sFas and related serum factors for septic patients with Escherichia coli infections

目的探讨连续静脉-静脉血液透(CVVH)技术在治疗大肠埃希菌感染的脓毒血症患者,对其血清细胞色素C、可溶性Fas蛋白(sFas)的活性水平变化及相关血清因子的影响作用,为脓毒血症感染的临床治疗提供参考和借鉴。方法选取2014年7月-2016年8月收治的135例确诊的脓毒血症患者,随机分为研究组68例和对照组67例;对照组患者给予常规治疗,研究组患者在对照组的基础上采用CVVH技术进行治疗,对患者的血清细胞色素C、sFas的活性水平变化指标和血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)和白细胞介素-10(IL-10)进行观察和比较分析。结果治疗24h、3d和7d后,两组患者的血清细胞色素C和sFas的活性水平均降低,其中治疗7d后研究组患者指标显著低于对照组(P<0.05);研究组患者在治疗后相关血清因子指标变化明显,CRP、TNF-α、IL-6、IL-8、IL-10指标水平显著优于对照组(P<0.05)。结论CVVH技术能够在治疗大肠埃希菌感染脓毒血症中对患者的血清细胞色素C、sFas活性水平及相关血清因子的指标失衡有显著的改善作用。

OBJECTIVE To investigate the changes of activity levels and effect of related serum factors on serum cytochrome C and sFas（soluble Fas protein）of CVVH in the treatment of septic patients with Escherichia coli infections,so as to provide references for the clinical treatment of septic infection.METHODS A toatl of 135 cases of septic patients admitted to our hospital from Jan.2013 to Aug.2016 were selected.They were randomly divided into 68 patients in study group and 67 patients in control group.Patients in control group were treated with conventional therapy,and in study group were treated with CVVH on the basis of the control group.The changes of activity levels and related serum factors of serum cytochrome C,SFas,serum C-reactive protein（CRP）,tumor necrosis factor-α（TNF-α）,interleukin 6（IL-6）,interleukin 8（IL-8）and interleukin 10（IL-10）were observed and compared.RESULTS The activity levels of serum cytochrome C and sFas decreased in both groups at 24 h,3 d and 7 d after treatment,and the indexes in patients of study group at 7 dafter treatment were significantly lower than those of control group（P〈0.05）.The serum-related factors in study group changed significantly after treatment,and the test results of CRP,TNF-α,IL-6,IL-8,and IL-10 were significantly better than those in control group（P〈0.05）.CONCLUSIONCVVH can improve the activity of serum cytochrome C and sFas and the serum imbalance in the treatment of septic patients with E.coli infections.