连续性血液净化对重症急性胰腺炎并发多器官功能衰竭患者的疗效及对外周血炎症因子的影响
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摘要
目的探讨连续性血液净化治疗重症急性胰腺炎并发多器官功能衰竭(MODS)患者的效果及其对患者外周血炎症因子的影响。方法选取本院确诊为重症急性胰腺炎并发MODS的患者50例,根据治疗方法不同将其分为观察组(n=33)和对照组(n=17)。对照组仅采取常规治疗,而观察组在对照组基础上加用连续性血液净化治疗。分析比较这2组患者的住院时间、急性生理与慢性健康(APACHEⅡ)评分、治疗前后血清炎症因的变化。结果治疗后,2组平均住院时间、APACHEⅡ评分比较差异有统计学意义(P <0. 05);观察组外周血C反应蛋白(CRP)、白细胞介素-6 (IL-6)、白细胞介素-10(IL-10)和肿瘤坏死因子-α(TNF-α)水平均低于对照组,差异有统计学意义(P <0. 05)。结论连续性血液净化治疗重症急性胰腺炎并发MODS患者具有良好的临床疗效,可显著降低患者外周炎症因子的水平,有效提高治愈能力。
Objective To investigate the effect of continuous blood purification in treatment of patients with severe acute pancreatitis complicated with multiple organ dysfunction syndrome( MODS) and its influence on peripheral blood inflammatory factors. Methods A total of 50 patients with severe acute pancreatitis complicated with MODS were divided into observation group( n = 33)and control group( n = 17) according to the different treatment methods. The control group only took conventional treatment,while the observation group added continuous blood purification treatment.According to the data collected,the clinical hospitalization time,APACHE Ⅱ score,and serum inflammatory factors in the two groups were analyzed and compared before and after treatment. Results After active treatment,the average length of hospital stay,and APACHE Ⅱ score of two groups showed significant difference( P < 0. 05). The peripheral blood C-reactive protein( CRP),interleukin-6( IL-6),interleukin-10( IL-10) in the observation group were lower than those in the control group( P < 0. 05). Conclusion Continuous blood purification for severe acute pancreatitis complicated with MODS has a good clinical effect,which can significantly reduce the level of peripheral inflammatory factors,and improve the effective healing ability.
Objective To investigate the effect of continuous blood purification in treatment of patients with severe acute pancreatitis complicated with multiple organ dysfunction syndrome( MODS) and its influence on peripheral blood inflammatory factors. Methods A total of 50 patients with severe acute pancreatitis complicated with MODS were divided into observation group( n = 33)and control group( n = 17) according to the different treatment methods. The control group only took conventional treatment,while the observation group added continuous blood purification treatment.According to the data collected,the clinical hospitalization time,APACHE Ⅱ score,and serum inflammatory factors in the two groups were analyzed and compared before and after treatment. Results After active treatment,the average length of hospital stay,and APACHE Ⅱ score of two groups showed significant difference( P < 0. 05). The peripheral blood C-reactive protein( CRP),interleukin-6( IL-6),interleukin-10( IL-10) in the observation group were lower than those in the control group( P < 0. 05). Conclusion Continuous blood purification for severe acute pancreatitis complicated with MODS has a good clinical effect,which can significantly reduce the level of peripheral inflammatory factors,and improve the effective healing ability.
引文
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[9]吴才胜,李少霞,甘敏.泮托拉唑联合生长抑素治疗急性胰腺炎对血清炎症因子及疗效影响[J].中国实用医药,2016,11(20):145-146.
[10]杨永俊.乌司他丁治疗急性重症胰腺炎的疗效及对血清炎症因子水平的影响[J].中国实用医药,2016,11(4):105-106.
[11]布合力其·麦麦提,张蕾,莫颖.血液净化治疗多器官功能障碍综合征患者36例临床观察[J].中国医药指南,2017,15(10):39-40.
[12]何联义,刘海兰,唐喜宁,等.连续性血液净化对多器官功能障碍综合征患者炎性介质、血流动力和凝血功能的影响[J].中国医学装备,2018,15(8):76-80.
[13] Liu H B,Zhang M,Zhang J X,et al. Application of bedside continuous blood purification in patients with multiple organ dysfunction syndromes[J]. World J Emerg Med,2012,3:40-43.
[14]任夏,方振波,彭春艳,等.血管生成素及其他炎症介质在大鼠急性胆源性胰腺炎中的变化规律及意义[J].南京医科大学学报:自然科学版,2017,37(1):48-52.
[15] Escobar J,Pereda J,Arduini A,et al. Cross-talk between oxidative stress and pro-inflammatory cytokines in acute pancreatitis:a key role for protein phosphatases[J]. Curr Pharm Des,2009,15:3027-3042.
[2]余贤恩.急性胰腺炎流行病学及严重性预测评估研究进展[J].胃肠病学和肝病学杂志,2015,24(2):234-237.
[3]薛爱华.急性胰腺炎消化内科治疗临床效果分析[J].世界最新医学信息文摘,2018,18(75):63-63.
[4] Apodaca-Torrez F R,Lobo E J,Monteiro L M,et al. Severe acute pancreatitis:results of treatment[J]. Rev Col Bras Cir,2012,39:385-388.
[5]郝明玉.重症急性胰腺炎早期并发多脏器功能障碍综合征的危险因素分析[J].医药前沿,2015(22):163-164.
[6] Ramirez M. Multiple organ dysfunction syndrome. Curr Probl Pediatr Adolesc Health Care,2013,43:273-277.
[7] Gasparovic V,Dakovic K,Gornik I,et al. Severe acute pancreatitis as a part of multiple dysfunction syndrome. Coll Antropol,2014,38:125-128.
[8]谢代刚,汪蓓蓓,蔡华仔.生长抑素联合奥美拉唑治疗急性胰腺炎的疗效及对患者血清炎症因子水平的影响[J].海南医学,2018,29(8):1066-1068.
[9]吴才胜,李少霞,甘敏.泮托拉唑联合生长抑素治疗急性胰腺炎对血清炎症因子及疗效影响[J].中国实用医药,2016,11(20):145-146.
[10]杨永俊.乌司他丁治疗急性重症胰腺炎的疗效及对血清炎症因子水平的影响[J].中国实用医药,2016,11(4):105-106.
[11]布合力其·麦麦提,张蕾,莫颖.血液净化治疗多器官功能障碍综合征患者36例临床观察[J].中国医药指南,2017,15(10):39-40.
[12]何联义,刘海兰,唐喜宁,等.连续性血液净化对多器官功能障碍综合征患者炎性介质、血流动力和凝血功能的影响[J].中国医学装备,2018,15(8):76-80.
[13] Liu H B,Zhang M,Zhang J X,et al. Application of bedside continuous blood purification in patients with multiple organ dysfunction syndromes[J]. World J Emerg Med,2012,3:40-43.
[14]任夏,方振波,彭春艳,等.血管生成素及其他炎症介质在大鼠急性胆源性胰腺炎中的变化规律及意义[J].南京医科大学学报:自然科学版,2017,37(1):48-52.
[15] Escobar J,Pereda J,Arduini A,et al. Cross-talk between oxidative stress and pro-inflammatory cytokines in acute pancreatitis:a key role for protein phosphatases[J]. Curr Pharm Des,2009,15:3027-3042.