薛茫. 连续性肾脏替代疗法对重症急性肾衰竭患者微炎症状态及肾功能影响的临床观察[J]. 临床肾脏病杂志, 2017, 17(12): 744-747. DOI: 10.3969/j.issn.1671-2390.2017.12.008
    引用本文: 薛茫. 连续性肾脏替代疗法对重症急性肾衰竭患者微炎症状态及肾功能影响的临床观察[J]. 临床肾脏病杂志, 2017, 17(12): 744-747. DOI: 10.3969/j.issn.1671-2390.2017.12.008
    shu
    XUE Mang. Effect of continuous renal replacement therapy on micro-inflammatory state and renal function in patients with severe acute renal failure[J]. Journal of Clinical Nephrology, 2017, 17(12): 744-747. DOI: 10.3969/j.issn.1671-2390.2017.12.008
    Citation: XUE Mang. Effect of continuous renal replacement therapy on micro-inflammatory state and renal function in patients with severe acute renal failure[J]. Journal of Clinical Nephrology, 2017, 17(12): 744-747. DOI: 10.3969/j.issn.1671-2390.2017.12.008
    shu

    连续性肾脏替代疗法对重症急性肾衰竭患者微炎症状态及肾功能影响的临床观察

    Effect of continuous renal replacement therapy on micro-inflammatory state and renal function in patients with severe acute renal failure

      摘要
    • 摘要: 目的 探究连续性肾脏替代疗法对重症急性肾衰竭患者微炎症状态及肾功能的影响。方法 选择2014年11月至2016年11月中国人民解放军三零七医院收治的84例重症急性肾衰竭患者，分为两组，即观察组采用连续性肾脏替代疗法治疗，对照组采用间歇性血液透析治疗。治疗后对比两组疗效；观察并对比白细胞介素-6（interleukin-6，IL-6）、白细胞介素-8（interleukin-8，IL-8）、超敏C反应蛋白（hypersensitive C-reactive protein，hs-CRP）、肿瘤坏死因子-α（tumor necrosis factors-α，TNF-α）等炎症因子水平以及血清肌酐（SCr）、内生肌酐清除率（creatinine clearance，Ccr）、尿素氮（BUN）、胆碱酯酶（cholinesterase，CHE）等肾功能指标；行APACHEⅡ评分并观察并发症情况。结果 治疗后观察组总有效率显著高于对照组（92.86%vs. 76.19%，P<0.05）；治疗后2组IL-6、IL-8、hs-CRP、TNF-α水平均显著低于治疗前，且观察组更为显著（P<0.05）；治疗后2组SCr、BUN水平显著低于治疗前，Ccr、CHE水平显著高于治疗前，且观察组更为显著（P<0.05）；治疗前观察组和治疗组的APACHE Ⅱ评分差异无统计学意义（P>0.05），治疗后观察组低于对照组（14.83±3.84 vs. 22.73±6.97，P<0.05）；常见的不良反应有低血压和心律失常，观察组的低血压发生率、心律失常发生率均显著低于对照组（4.76%vs. 14.29%，2.38%vs. 11.90%，P<0.05）。结论 重症急性肾衰竭患者采用连续性肾脏替代疗法治疗，能够显著改善微炎症状态，提高肾功能，控制并发症发生，疗效显著。

       

      Abstract: Objective To investigate the effect of continuous renal replacement therapy on micro inflammatory state and renal function in patients with severe acute renal failure.Methods Eighty-four cases of severe acute renal failure were treated in our hospital from November 2014 to November 2016, and randomly divided into two groups:the observation group receiving continuous renal replacement therapy, and the control group given intermittent hemodialysis treatment. The curative effectiveness of the two groups was compared after treatment. The levels of inflammatory factors such as IL-6, IL-8, hs-CRP, TNF-α and SCr, CCr, BUN, CHE and other renal function indexes were observed and compared. APACHE Ⅱ score and complications were observed.Results After treatment, the total effective rate in the observation group was significantly higher than that in the control group (92.86% vs. 76.19%, P<0.05). After treatment, the levels of IL-6, IL-8, hs-CRP and TNF-α in the two groups were significantly lower than those before the treatment, and those in the observation group were significantly lower than in the control group (P<0.05). The SCr and BUN levels after treatment in the two groups were significantly lower, and Ccr and CHE levels were significantly higher than those before treatment, more significantly in the observation group (P<0.05). There were no significant differences in APACHE Ⅱ scores between the observation group and the control group before treatment (P>0.05). After treatment, APACHE Ⅱ scores in the observation group were lower than those in the control group (14.83±3.84 vs. 22.73±6.97, P<0.05). The common adverse reactions were hypotension and arrhythmia. The incidence of hypotension and arrhythmia in the observation group was significantly lower than that in the control group (4.76% vs. 14.29%, and 2.38% vs. 11.90%, P<0.05).Conclusions Continuous renal replacement therapy in patients with severe acute renal failure can significantly improve the state of micro inflammation and renal function, and control complications, and the curative effectiveness is remarkable.

       

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