本文關(guān)鍵詞： 多種模式腎臟替代治療 急性腎功能衰竭 全身炎癥反應(yīng)綜合征　出處：《細(xì)胞與分子免疫學(xué)雜志》2016年09期 　論文類型：期刊論文

【摘要】：目的探討雜合式腎臟替代治療對(duì)急性腎功能衰竭伴全身炎癥反應(yīng)綜合征高齡患者的臨床療效。方法回顧性選取由重癥肺炎、心臟疾病及腦血管意外引起的全身炎癥反應(yīng)綜合征合并急性腎功能衰竭高齡患者38例,分為雜合式連續(xù)性靜脈-靜脈血液透析濾過聯(lián)合血漿置換(CVVHDF-PE)組(n=20)及對(duì)照組(同時(shí)期患者或家屬不愿接受血液凈化治療者,n=18),比較2種治療方式對(duì)患者急性生理與慢性健康(APACHEⅡ)評(píng)分、血清肌酐(Scr)、白細(xì)胞介素10(IL-10)、IL-6、腫瘤壞死因子α(TNF-α)水平,血?dú)夥治鲋笜?biāo),CD4~+T細(xì)胞、CD8~+T細(xì)胞數(shù)量,CD4~+/CD8~+T細(xì)胞比率及患者存活率的影響。結(jié)果與對(duì)照組相比,CVVHDF-PE組治療后APACHEⅡ評(píng)分、Scr、IL-10、IL-6、TNF-α水平明顯下降;p H值升高、p CO2升高、HCO3-升高;CVVHDF-PE組治療后CD4~+T細(xì)胞、CD4~+/CD8~+T細(xì)胞比例較前顯著升高,CD8~+T細(xì)胞較治療前明顯下降,對(duì)照組的上述免疫功能指標(biāo)治療前后無明顯差異;CVVHDF-PE組存活率明顯高于對(duì)照組。結(jié)論重癥肺炎、心臟疾病及腦血管意外引起的全身炎癥反應(yīng)綜合征合并急性腎功能衰竭時(shí),在常規(guī)治療基礎(chǔ)上,盡早應(yīng)用雜合式腎臟替代治療能有效清除體內(nèi)多種毒素及炎癥介質(zhì),糾正酸堿平衡紊亂,改善免疫抑制狀態(tài)及臨床癥狀,提高對(duì)高齡患者的救治成功率。
[Abstract]:Objective to investigate the clinical efficacy of heterozygous renal replacement therapy in elderly patients with acute renal failure and systemic inflammatory response syndrome. Thirty-eight elderly patients with systemic inflammatory response syndrome associated with acute renal failure caused by heart disease and cerebrovascular accidents, The patients were divided into two groups: the heterozygous continuous venous hemodiafiltration (CVV HDF-PEV) group and the control group (patients or relatives who were not willing to undergo blood purification therapy at the same time). Sexual health assessment (Apache 鈪，

本文編號(hào)：1520462