血液灌流联合血液透析滤过对高脂血症胰腺炎伴急性肾损伤的疗效研究

Curative efficacy of the combination of hemoperfusion and hemodiafiltration on hyperlipidemic pancreatitis complicated with acute kidney injury

目的探讨高脂血症胰腺炎伴急性肾损伤实施血液灌流与血液透析滤过联合治疗的临床效果。方法选取2013年3月~2016年2月期间我院收治的86例高脂血症胰腺炎伴急性肾损伤患者,采用双盲法随机将患者分为单用组(血液透析滤过疗法)、联合组(血液灌流+血液透析滤过),每组43例,评估疾病治疗效果,观察治疗前后各项指标变化情况。另选取43例健康人作为对照组。结果联合组治疗后48、72h血清TG、IL-6、TNF-α、Cr、BUN水平及APACHE评分下降幅度显著优于单用组,差异具有统计学意义(P<0.05)。结论血液灌流和血液透析滤过联合治疗高脂血症胰腺炎伴急性肾损伤,有效清除患者体内炎性介质,提高肾功能保护作用,疗效显著,可作为临床辅助疗法,具有推广价值。

Objective To investigate the clinical efficacy of implementing the combination of hemoperfusion and hemodiafiltration on patients with hyperlipidemic pancreatitis complicated with acute kidney injury. Methods 86 cases of patients with hyperlipidemia pancreatitis complicated with acute kidney injury cured in our hospital from March 2013 to February 2016 were selected and divided into single e group（hemodiafiltration therapy） and combination gr（hemoperfusion and hemodiafiltration） by adopting double blind method with 43 cases in each group. The changes of indexes before and after treatment were observed. Another 43 healthy people were selected as control group. Results After treatment, the TG, IL-6, TNF- α, Cr, BUN level and APACHE scores of the combined group after 48h and 72h were significantly lower than those of the single group. The falling range of APACHE score was significantly lower than that of the single group and the difference was significant with P 〈 0.05. Conclusion Implementing the combination of hemoperfusion and hemodiafiltration on patients with hyperlipidemic pancreatitis complicated with acute kidney injury can effectively remove patients＇ inflammatory mediators, and it can improve the protection of renal function with significant effect so that it can be used as a clinical adjuvant therapy and has promotional value.