论文部分内容阅读
目的探讨连续性血液净化治疗(CBP)对代偿性抗炎反应综合征(CARS)的疗效。方法收集2012年5月至2015年12月解放军第202医院血液透析中心、重症监护病房(ICU)由于各种原因致全身炎症反应综合征(SIRS)的患者30例,所有患者均行CBP治疗60 h。采用股静脉临时血液透析留置导管,采用FRESENIUS CBP治疗机;选用AV-600滤器,面积为2.0 m~2进行前稀释连续性静脉-静脉血液滤过(CVVH)。在治疗0 h、6 h、12 h、24 h、48 h、60 h分别采血检测IL-4、IL-10等抗炎性介质及干扰素-γ(IFN-γ)浓度。结果 CBP治疗后外周血单核细胞分泌IL-4、IL-10表达均上升(P<0.05),IFN-γ浓度略下降。而血WBC由治疗前的明显升高降至接近正常(P<0.05)。结论 CBP治疗不仅能清除炎症介质,同时使抗炎症介质表达增加,Th1/Th2细胞因子表达变化有利于恢复患者免疫细胞功能。
Objective To investigate the effect of continuous blood purification (CBP) on compensatory anti-inflammatory response syndrome (CARS). Methods Thirty patients with systemic inflammatory response syndrome (SIRS) from hemodialysis center and ICU of the 202nd Hospital of People’s Liberation Army from May 2012 to December 2015 were collected, and all patients were treated with CBP 60 h Femoral venous temporary hemodialysis indwelling catheter, the use of FRESENIUS CBP treatment machine; use AV-600 filter, an area of 2.0 m ~ 2 pre-dilution continuous venovenous hemofiltration (CVVH). The anti-inflammatory mediators such as IL-4 and IL-10 and the concentration of interferon-γ (IFN-γ) were determined at 0 h, 6 h, 12 h, 24 h, 48 h and 60 h after treatment. Results The levels of IL-4 and IL-10 secreted by peripheral blood mononuclear cells increased after CBP treatment (P <0.05), and the concentration of IFN-γ slightly decreased. Blood WBC decreased from the pre-treatment level to near normal level (P <0.05). Conclusion CBP treatment can not only clear the inflammatory mediators, but also increase the expression of anti-inflammatory mediators, and the changes of Th1 / Th2 cytokines are beneficial to the recovery of immune cell function in patients.