早期连续性肾脏替代疗法对重症感染患者炎症状态及预后的影响研究

Influence of early continuous renal replacement therapy on inflammatory state and prognosis in patients with severe infection

目的分析早期连续性肾脏替代疗法(CRRT)对重症感染患者炎症状态及预后的影响。方法60例重症感染患者,以数字抽签法分为实验组和参照组,各30例。参照组采用常规方法治疗,实验组在参照组基础上采用早期CRRT治疗。比较两组患者治疗前后炎症因子(C反应蛋白、降钙素原、肿瘤坏死因子-α、白细胞介素-6)水平及生活质量(躯体健康、物质生活、社会功能、心理健康)评分。结果治疗后,两组患者肿瘤坏死因子-α、白细胞介素-6、降钙素原、C反应蛋白水平均低于治疗前,且实验组患者肿瘤坏死因子-α(9.23±1.45)ng/L、白细胞介素-6(14.24±4.35)pg/ml、降钙素原(2.13±0.46)μg/L、C反应蛋白(2.13±0.62)mg/L均低于参照组的(12.42±1.76)ng/L、(19.45±5.31)pg/ml、(2.61±0.81)μg/L、(3.51±1.12)mg/L,差异有统计学意义(P<0.05)。实验组患者社会功能、躯体健康、心理健康、物质生活评分分别为(59.25±5.32)、(58.45±5.68)、(46.52±5.12)、(56.18±5.22)分,均明显高于参照组的(51.07±5.92)、(50.25±7.25)、(38.63±3.48)、(50.48±5.63)分,差异有统计学意义(P<0.05)。结论对重症感染患者采用早期CRRT治疗可降低机体炎症反应,对改善患者生活质量、促进患者恢复有重要作用,值得临床大力推广。

Objective To analyze the influence of early continuous renal replacement therapy(CRRT)on inflammatory state and prognosis in patients with severe infection.Methods A total of 60 patients with severe infection were divided into experimental group and reference group by digital lottery,with 30 cases in each group.The reference group was treated with conventional methods,and the experimental group was treated with early CRRT on the basis of the reference group.The levels of inflammatory factors(C-reactive protein,procalcitonin,tumor necrosis factor-α,interleukin-6)and quality of life(physical health,material life,social function,and mental health)score before and after treatment were compared between the two groups.Results After treatment,the levels of tumor necrosis factor-α,interleukin-6,procalcitonin and C-reactive protein in the two groups were lower than those before treatment in this group;in the experimental group,the tumor necrosis factor-αwas(9.23±1.45)ng/L,the interleukin-6 was(14.24±4.35)pg/ml,the procalcitonin was(2.13±0.46)μg/L,and the C-reactive protein was(2.13±0.62)mg/L,which were lower than(12.42±1.76)ng/L,(19.45±5.31)pg/ml,(2.61±0.81)μg/L,and(3.51±1.12)mg/L in the reference group;the differences were all statistically significant(P<0.05).The scores of social function,physical health,mental health,and material life in the experimental group were(59.25±5.32),(58.45±5.68),(46.52±5.12),and(56.18±5.22)points,which were significantly higher than(51.07±5.92),(50.25±7.25),(38.63±3.48),and(50.48±5.63)points in the reference group,and the differences were statistically significant(P<0.05).Conclusion The use of early CRRT for patients with severe infections can reduce the inflammatory response of the body,which plays an important role in improving patients'quality of life and promoting their recovery,and is worthy of vigorous clinical promotion.