连续性血液净化对ICU脓毒症患者血清LA、PCT、CRP水平以及预后的影响

Effect of continuous blood purification on serum LA,PCT,CRP levels and prognosis in ICU patients with sepsis

目的探讨连续性血液净化对ICU脓毒症患者血清乳酸(LA)、降钙素原(PCT)、C反应蛋白(CRP)水平及预后的影响。方法选取2017年2月至2019年1月我院ICU收治的脓毒症患者70例为研究对象,随机分为对照组和观察组,每组35例。两组患者均接受重度脓毒症常规治疗。在此基础上,对照组患者给予乌司他丁治疗;观察组患者给予乌司他丁+连续性血液净化治疗。检测比较两组患者治疗前后的血清LA、PCT、CRP水平;比较两组患者住ICU治疗时间、治疗后28 d的死亡情况。结果治疗前,两组患者的血清LA、PCT、CRP水平比较,差异无统计学意义(P>0.05);治疗1周后,两组患者的血清LA、PCT、CRP水平均显著降低,观察组的水平显著低于对照组,差异有统计学意义(P<0.05)。观察组患者住ICU治疗时间、治疗后28 d病死率均低于对照组,差异有统计学意义(P<0.05)。结论连续性血液净化治疗可显著降低住ICU脓毒症患者的血清LA、PCT、CRP水平,有效抑制炎症反应,对促进患者康复、改善预后具有重要作用。

Objective To investigate the effect of continuous blood purification on serum lactic acid(LA),procalcitonin(PCT),C-reactive protein(CRP)levels and prognosis in ICU patients with sepsis.Methods A total of 70 patients with sepsis admitted to our hospital from February 2017 to January 2019 were selected as the research subjects and randomly divided into control group and observation group,with 35 cases in each group.Both groups received routine treatment for severe sepsis,based on which the control group was administered ulinastatin,whereas the observation group with ulinastatin+continuous blood purification treatment.Serum LA,PCT,CRP levels before and after treatment between the two groups were detected and compared.The ICU stays and twenty-eight-day mortality after therapy between the two groups were compared.Results Before treatment,there were no statistically significant differences in serum LA,PCT,and CRP levels between the two groups(P>0.05).After 1 week of treatment,serum LA,PCT,and CRP levels in the two groups decreased significantly,and the levels in the observation group were significantly lower than those in the control group,with statistically significant differences(P<0.05).The ICU stays and twenty-eight-day mortality after therapy in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).Conclusion Continuous blood purification treatment can significantly decrease serum LA,PCT,and CRP levels in ICU patients with sepsis,which can effectively inhibit the inflammatory response,which plays an important role in promoting the recovery of patients and improving prognosis.