论文部分内容阅读
目的:探讨连续性血液净化(CBP)治疗对多发伤后并发脓毒症患者血清血管生成素(Ang-2)、TNF-α与IL-18水平及预后的影响。方法:选择73例多发伤后并发脓毒症患者,按照是否接受连续性血液净化治疗分为常规治疗组35例和连续性血液净化治疗组38例,监测治疗前后临床疗效及预后,并分别在治疗前和治疗后6 h、12 h、24 h、48 h各时间点采用ELISA检测两组患者血清Ang-2、TNF-α、IL-18水平的变化。结果:经72 h治疗后,CBP治疗组患者在APACHEⅡ评分和ICU住院时间明显优于常规治疗组,且MODS发生率和住院期间死亡率均明显低于常规治疗组,两组间比较有统计学差异(P<0.05)。CBP治疗组患者血清Ang-2、TNF-α、IL-18水平均较治疗前明显降低(P<0.05),组间比较,CBP治疗组患者的各时间点血清Ang-2、TNF-α、IL-18水平均明显低于常规治疗组。结论:CBP是改善多发伤后并发脓毒症患者预后的有效治疗方法,清除患者血清中过多Ang-2、TNF-α和IL-18水平,可能是改善预后的重要机制之一。
Objective: To investigate the effects of continuous blood purification (CBP) on the serum levels of angiopoietin (Ang-2), TNF-α and IL-18 and their prognosis in patients with multiple traumatic sepsis. Methods: Seventy-three patients with sepsis after multiple injuries were divided into routine treatment group (n = 35) and continuous blood purification group (n = 38) according to whether they were treated with continuous blood purification or not, and the clinical efficacy and prognosis were monitored before and after treatment The levels of serum Ang-2, TNF-α and IL-18 in the two groups were measured by ELISA before treatment, 6 h, 12 h, 24 h, 48 h after treatment. Results: After 72 h of treatment, the APACHE II score and ICU stay in CBP group were significantly better than those in routine treatment group, and the incidence of MODS and in-hospital mortality were significantly lower than those in the conventional treatment group Difference (P <0.05). The levels of serum Ang-2, TNF-α and IL-18 in CBP treatment group were significantly lower than those before treatment (P <0.05). The levels of serum Ang-2, IL-18 levels were significantly lower than the conventional treatment group. Conclusion: CBP is an effective treatment to improve the prognosis of patients with sepsis complicated by multiple trauma. Clearing the levels of serum Ang-2, TNF-α and IL-18 in serum may be one of the important mechanisms to improve prognosis.