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目的观察急性肾衰竭(ARF)患者体内炎症因子的表达情况及血液灌流对其的清除效果。方法选择山西医科大学第二医院肾内科确诊的肾性单纯型ARF患者76例,随机分为两组:血液灌流联合血液透析组(HP+HD组)和单纯血液透析组(HD组),每组各38例,分别于治疗前、后采血;健康人25例作为对照组;ELISA方法检测血中C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)水平。结果透析及灌流治疗前两组患者血CRP、IL-6、TNF-α水平均高于正常对照组(P<0.001),两组之间各因子水平差异无显著性(P>0.05);透析及灌流治疗前3组各因子相互之间呈显著正相关(P<0.001);透析及灌流治疗后各因子水平较治疗前降低,其中(HP+HD)组差异有统计学意义(P<0.001),HD组差异无统计学意义(P>0.05)。结论ARF患者可能存在类似慢性肾衰竭(CRF)的微炎症状态,血液灌流是其有效的治疗手段。
Objective To observe the expression of inflammatory cytokines in acute renal failure (ARF) patients and the clearance effect of hemoperfusion. Methods Sixty-six patients with renal-type ARF diagnosed in Department of Nephrology, Second Hospital of Shanxi Medical University were randomly divided into two groups: hemoperfusion group (HP + HD group) and hemodialysis group (HD group) (N = 38). Blood samples were collected before and after treatment respectively. Twenty-five healthy people were served as the control group. Serum C-reactive protein (CRP), interleukin 6 (IL-6) and tumor necrosis factor alpha -α) levels. Results The blood levels of CRP, IL-6 and TNF-α in the two groups before dialysis and perfusion therapy were significantly higher than those in the normal control group (P <0.001). There was no significant difference in the levels of each factor between the two groups (P> 0.05) (P <0.001). The levels of each factor after dialysis and perfusion therapy were lower than those before treatment (P <0.001, P <0.001) ), There was no significant difference in HD group (P> 0.05). Conclusion ARF patients may have micro-inflammatory status similar to chronic renal failure (CRF). Hemoperfusion is an effective treatment.