摘要
目的比较AN69-oXiris和AN69-ST滤器在重症急性胰腺炎(SAP)患者中的有效性。方法回顾性分析2020年11月—2022年4月在昆山市第一人民医院ICU收治的应用AN69-oXiris和AN69-ST滤器行连续性肾脏替代治疗(CRRT)的SAP患者临床资料。比较患者接受AN69-oXiris和AN69-ST滤器行CRRT治疗前(T0)及治疗24 h后(T1)的内毒素(E)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、白细胞计数(WBC)、血清降钙素原(PCT)、C-反应蛋白(CRP)、平均动脉压(MAP)、心率(HR)、血管活性药物评分(VIS)、血乳酸(Lac)、急性生理学与慢性健康状况评价Ⅱ(APACHEⅡ)评分、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血小板计数(PLT)、血肌酐(SCr)以及预后情况。结果共纳入37例SAP患者,其中21例使用AN69-oXiris滤器,16例使用AN69-ST滤器。经过血液净化治疗后,AN69-oXiris组在T1时的E、IL-6、IL-8、TNF-α明显降低(均P<0.05);两组患者的PCT、CRP、WBC、HR、SCr水平均降低(均P<0.05),且与AN69-ST组比较,AN69-oXiris组HR降低更明显(P<0.05)。但两组间在住院时间及死亡率方面差异无统计学意义(均P>0.05)。结论SAP患者使用AN69-oXiris或AN69-ST滤器进行血液净化治疗后在炎症反应和器官功能方面均有所改善,但AN69-oXiris滤器在清除E、IL-6、IL-8、TNF-α和降低心率方面更有优势。
Objective To compare the efficacy of AN69-oXiris and AN69-ST filters in patients with severe acute pancreatitis(SAP).Methods Clinical data of patients with SAP who received continuous renal replacement therapy(CRRT)with AN69-oXiris and AN69-ST filter were retrospectively analyzed in the ICU of Kunshan First People's Hospital from November 2020 to April 2022.Endotoxin(E),interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α),white blood cell count(WBC),serum procalcitonin(PCT),C-reactive protein(CRP),mean arterial pressure(MAP),heart rate(HR),vasoactive inotropic score(VIS),blood lactate(Lac),Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)score,prothrombin time(PT),activated partial thromboplastin time(APTT),platelet count(PLT),serum creatinine(SCr),and prognosis were compared before treatment with AN69-oXiris and AN69-ST filter for CRRT(T0)and 24h after treatment(T1).Results 37 patients with SAP were included,of which 21 were treated with AN69-oXiris filter and 16 were treated with AN69-ST filter.After blood purification treatment,the levels of E,IL-6,IL-8 and TNF-αin AN69-oXiris group at T1 were significantly decreased(all P<0.05).The levels of PCT,CRP,WBC,HR and SCr in both groups were decreased(all P<0.05),and HR in AN69-oXiris group was more significantly decreased than that in AN69-ST group(P<0.05).However,there were no significant differences in length of hospital stay and mortality between the two groups(all P>0.05).Conclusion Patients with SAP who received blood purification treatment with AN69-oXiris or AN69-ST filter showed improvement in inflammatory response and organ function,but AN69-oXiris filter was superior in clearing E,IL-6,IL-8,TNF-αand reducing heart rate.
作者
赵瑾
彭媛
倪春华
金芳
ZHAO Jin;PENG Yuan;NI Chun-hua;JIN Fang(Department of Critical Care Medicine,Kunshan First People's Hospital,Kunshan,Jiangsu,215300,China)
出处
《中国血液流变学杂志》
CAS
2024年第2期254-259,共6页
Chinese Journal of Hemorheology
基金
江苏大学医教协同创新基金(JDY2022014)。