连续肾脏替代治疗对脓毒症炎症因子清除作用的研究进展

Advances in Continuous Renal Replacement Therapy for Clearance of Inflammatory Cytokines in Sepsis

连续肾脏替代治疗(continuous renal replacement therapy,CRRT)是治疗脓毒症的主要方式之一,结合血液透析原理,能够有效地清除激活全身炎症反应的炎症介质、内毒素及细胞因子、补体、炎症细胞等,阻止脓毒症的发生与进展。国内外的大量研究已证实CRRT治疗脓毒症的高效性,但目前尚无可靠的生物标志物来评估其对脓毒症炎性因子的清除作用及预后。文章通过分析近年来CRRT治疗脓毒症的相关文献,总结不同炎性因子的表达特点以及脓毒症患者炎症反应的进展过程,深入了解CRRT对不同炎性因子的清除作用,以期进一步明确CRRT对脓毒症的治疗效果,从而为临床危重病中CRRT的应用提供理论基础。

Continuous renal replacement therapy(CRRT)is one of the main methods for the treatment of sepsis.Combined with the principle of hemodialysis,it can effectively remove inflammatory mediators,endotoxins,cytokines,complements and inflammatory cells to prevent the occurrence and progression of sepsis.A large number of studies have confirmed the effectiveness of CRRT in the treatment of sepsis.However,there is no reliable biomarker to evaluate the efficacy and prognosis of CRRT for clearance of inflammatory factors.In order to clarify the therapeutic effect of CRRT on sepsis and provide a theoretical basis for clinical application of CRRT in critical patients,we analyze the recent literature on the treatment of sepsis with CRRT to summarize the expression characteristics of different inflammatory factors and the progress of inflammatory response and to further understand the scavenging effect of CRRT on inflammatory factors.