连续性血液净化对重症脓毒症患者炎症因子及血流动力学的影响

Eflfect of CBP on Inflammatory Factors and Hemodynamics in Patients with Severe Sepsis

目的观察连续性血液净化对重症脓毒症患者炎症因子及血流动力学的影响。方法选取本院2018年2月~2019年3月收治的重症脓毒症患者86例,将其分为两组,各43例。对照组给予针对性的综合治疗,在此基础上,观察组给予连续性血液透析治疗,观察两组炎症因子、血流动力学及免疫功能指标。结果①IL-10:对照组33.21±3.64(μg/L),观察组35.84±3.72(μg/L),组间差异有统计学意义(P<0.05);②TNF-α、CRP:观察组112.34±13.25(mg/L)、50.12±5.11(mg/L),对照组138.67±15.64(mg/L)、57.98±7.24(mg/L),组间差异有统计学意义(P<0.05);③心率、呼吸频率:对照组均高于观察组,平均动脉压低于观察组,差异有统计学意义(P<0.05);④对照组CD3+、CD4+均低于观察组,差异有统计学意义(P<0.05)。结论 CBP能改善血流动力学指标,减轻脓毒症病情的严重程度。

Objective:To investigate the efiect of continuous blood purification(CBP)on inflammatory factors and hemodynamics in patients with severe sepsis.Methods:Totally,86 patients with severe sepsis were admitted and treated in Dengfeng People's Hospital from February 2018 to March 2019.They randomly were divided into test group(n=43)and control group(n=43).All patients were received routine treatment,while patients in test group received CBP additionally.The inflammatory factors,hemodynamics,and immunity function were compared between the two groups.Results:(1)The level of IL—10 in control group was 33.21±3.64(p,g/L),that in test group was 35.84±3.72(|x g/L),showing significant difierence(P<0.05).(2)The levels ofTNF—a and CRP in test were significantly lower than those in control group[112.34±13.25(mg/L)vs.138.67±15.64(mg/L)]>[50.12±5.11(mg/L)vs.57.98±7.24(mg/L)],respectively(P<0.05).⑶The HR and RR in test group were significantly higher than those in test group.However,the MAP in control group was significantly lower than that in test group(P<0.05).(4)The immunological parameter of CD3+and CD44-in control group weresignificantlyy lower than those in test group(P<0.05).Conclusions:CBP can improve the hemodynamic parameters,reducing the severity of sepsis.