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目的观察连续静脉-静脉血液滤过(CVVH)对脓毒症患者外周血高迁移率族蛋白-1(HMGB-1)、肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)水平的影响,探讨CVVH对脓毒症治疗的作用机制。方法对56例临床诊断脓毒症的患者共进行129例次CVVH治疗,收集治疗开始后0、4、8、24 h等时间点外周静脉血并检测HMGB-1、TNF-α、IL-6的浓度,比较上述指标在各时间点的差异性。结果治疗后HMGB-1水平虽有降低,但与治疗前比较差异无统计学意义(P>0.05);TNF-α、IL-6水平在治疗后明显降低,与治疗前比较差异有统计学意义(P<0.05)。结论 CVVH可降低脓毒症患者外周血中HMGB-1浓度,可部分清除体内TNF-α、IL-6;外周血中炎症因子的减少是CVVH治疗脓毒症的作用机制之一。
Objective To observe the effects of continuous veno-venous hemofiltration (CVVH) on the expression of HMGB-1, TNF-α, IL-6 ) Levels of CVVH on the mechanism of treatment of sepsis. Methods A total of 129 CVVH patients were treated in 56 clinically diagnosed sepsis patients. Serum levels of HMGB-1, TNF-α and IL-6 were measured at 0, 4, 8, 24 h after the start of treatment Of the concentration, compare the above indicators at different time points. Results Although the level of HMGB-1 decreased after treatment, there was no significant difference between the two groups before treatment (P> 0.05). The levels of TNF-α and IL-6 decreased significantly after treatment, with statistical significance (P <0.05). Conclusions CVVH can reduce the concentration of HMGB-1 in the peripheral blood of patients with sepsis and partially eliminate the levels of TNF-α and IL-6 in the sepsis. The reduction of inflammatory cytokines in peripheral blood is one of the mechanisms of CVVH in the treatment of sepsis.