持续静-静脉血液透析滤过治疗重症蜂蛰伤合并MODS的疗效研究

Study on effect of continuous veno-venous hemodiafiltration on severe bee sting complicating MODS

目的探究持续静-静脉血液透析滤过(CVVHDF)治疗重症蜂蛰伤合并多器官功能障碍综合征(MODS)的疗效。方法选取2016年2月至2019年2月西安交通大学医学院附属汉中三二○一医院接受治疗的80例重症蜂蛰伤合并MODS患者为研究对象,分为对照组、试验组各40例,对照组进行腹膜透析治疗,试验组进行CVVHDF治疗。对两组肝功能指标谷氨酰转肽酶(GGT)、丙氨酸氨基转移酶(ALT)和天门冬氨酸氨基转移酶(AST)水平及肾功能指标血肌酐(Scr)、血尿素氮(BUN)、胱抑素C(Cys-C)水平进行检测,ELISA法检测血清丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、白细胞介素(IL)-6、IL-10及肿瘤坏死因子-α(TNF-α)水平,统计两组并发症发生情况。结果与对照组比较,治疗后试验组GGT、ALT、AST、Scr、BUN、Cys-C、MDA、IL-6、IL-10和TNF-α水平更低,SOD、GSH-Px水平更高,差异有统计学意义(P<0.05)。试验组并发症发生率高于对照组,但差异无统计学意义(P>0.05)。结论对重症蜂蛰伤合并MODS患者进行CVVHDF治疗,能够改善其肝肾功能,提升抗氧化能力。

Objective To explore the effect of continuous veno-venous hemodiafiltration(CVVHDF)in the treatment of severe bee sting complicating multiple organ dysfunction syndrome(MODS).Methods Eighty patients with severe bee stings complicating MODS treated in the Affiliated Hanzhong 3201 Hospital of Medical College of Xi′an Jiaotong University from February 2016 to February 2019 were selected and divided into the control group and experiment group,40 cases in each group.The control group conducted the peritoneal dialysis treatment and the experiment group was treated with CVVHDF.The levels of glutamyltransferase(GGT),alanine aminotransferase(ALT),glutamic oxaloacetic transaminase(AST)and serum creatinine(Scr),blood urea nitrogen(BUN)and cystatin C(Cys-C)were measured in the two groups.Serum levels of malondialdehyde(MDA),superoxide dismutase(SOD),glutathione peroxidase(GSH-Px),interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)were detected by ELISA.The occurrence situation of complications in the two groups was counted.Results Compared with the control group,the levels of GGT,ALT,AST,Scr,BUN,Cys-C,MDA,IL-6,IL-10 and TNF-αaftr treatment in the experiment group lower,and the levels of SOD and GSH-Px were higher,the differences were statistically significant(P<0.05).The incidence rate of complications in the experiment group was higher than that in the control group,while the difference was not statistically significant(P>0.05).Conclusion CVVHDF could improve the liver and kidney function,enhance antioxidant capacity in the patients with severe bee sting complicating MODS.