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早期血液滤过对脓毒血症患者血浆IL-10和单核细胞人白细胞抗原-DR表达的影响 被引量:20

The Impacts of Early Continuous Veno-venous Hemofiltration on IL-10 and Monocyte Human Leukocyte Antigen-DR Expression in Septic Patients
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摘要 目的:探讨持续血液滤过开始时间对脓毒血症患者血浆IL-10和人白细胞抗原-DR表达的影响,评价血液滤过治疗效果。方法:选择本院ICU住院的40例脓毒血症患者,并按随机数字表法分为A组(早期血液滤过)和B组(晚期血液滤过)。在床旁持续血液滤过治疗开始后0 h、12 h、24 h、48 h、7 d分别采集血液标本并检测细胞因子IL-10和单核细胞人白细胞抗原-DR(HLA-DR)的表达。结果:血液滤过治疗后,血液中细胞因子IL-10较治疗前均有下降,HLA-DR的表达也有所提高,与治疗前相比差异有统计学意义(P<0.05)。但是A组与B组相比较,A组疗效优于B组(P<0.05)。经治疗后,A组患者APACHEⅡ评分较B组明显降低。结论:血液滤过治疗能显著减少血浆中的抗炎细胞因子IL-10的表达,早期进行血液滤过治疗,能更好的改善预后,减轻患者的危重程度,这可能与患者血浆中HLA-DR表达上调有关。 Objective:To investigate the impacts of early continuous veno-venous hemofiltration(CVVH)on plasma cytokines and monocyte human leukocyte antigen-DR(HLA-DR)expression and evaluate the relationship between them during CVVH treatment in septic patients. Method:Forty septic patients were enrolled in this study. They were randomly divided into group A(who received conventional treatment and CVVH treatment early in 48 h,n=20)and group B(who received conventional treatment and CVVH treatment 48h later,n=20). The blood samples were taken to measure the changes of IL-10 and HLA-DR expression on monocytes. Result:After CVVH treatment,the plasma levels of IL-10 in septic patients markedly decreased(P〈0.05). No matter early-treatment or later-treatment of CVVH,there was a negative correlation between plasma IL-10 and monocyte HLA-DR expression(P〈0.05). HLA-DR expression on monocytes improved in early CVVH treated patients(P〈0.05). Conclusion:Our findings suggest that CVVH be effective in removal of IL-10 and in improvement of monocyte HLA-DR expression in septic patients,and early CVVH in sepsis is better than later CVVH.
出处 《中国医学创新》 CAS 2014年第7期6-8,共3页 Medical Innovation of China
关键词 脓毒血症 血液滤过 白细胞介素-10 APACHEⅡ评分 IL-10 APACHEⅡ Sepsis Continuous veno-venous hemofihration Human leukocyte antigen-DR IL-10 APACHE II
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参考文献14

  • 1Angus D C, Linde-Zwirble W T, Lidicker J, et al. Epidemiology of severe sepsis in the United States : analysis of incidence, outcome, and associated costs of care[J]. Crit Care Med, 2001, 29 ( 7 ) : 1303- 1310.
  • 2Gogos A, Drosou E, Bassaris H P, et al. Pro-versus anti-inflammatory cytokine profile ih patients with severe sepsis: a marker for prognosis and future therapeutic options[J]. J Infect Dis, 2000, 181 ( 1 ) : 176- 180.
  • 3Hatherill M, Tibby S M, Turner C, et al. Proealcitonin and cytokine levels: relationship to organ failure and mortality in pediatric septic shock[J]. Crit Care Med, 2000, 28 ( 7 ) : 2591-2594.
  • 4Eskandari M K, Bolgos G, Miller C, et al. Anti-tumor necrosis factor antibody therapy fails to prevent lethality after cecal ligation and puncture or endotoxemia[J]. J Immunol, 1992, 148 (9) : 2724- 2730.
  • 5Echtenaeher B, Weigl K, Lehn N, et al. Tumor necrosis factor- dependent adhesions as a major protective mechanism early in septic peritonitis in mice[J]. Infect Immun, 2001, 69 ( 6 ) : 3550-3555.
  • 6Ruffell A J. The utilization of continuous veno-venous hemofiltration for the removal of septic mediators in patients with systemic inflammatory response syndrome[J]. Intensive Crit Care Nuts, 2003, 19 (4) : 207-214.
  • 7Heering P, Grabensee B, Brause M. Cytokine removal in septic patients with continuous venovenous hemofiltration[J]. Kidney Blood Press Res, 2003, 26 (2) : 128-134.
  • 8丁燕晶,陈甘海,李金庭.连续性血液净化在治疗重症脓毒血症中的应用[J].中国医学创新,2012,9(14):16-17. 被引量:33
  • 9崔乃强,吴咸中.重症急性胰腺炎治疗的现况和展望[J].中国危重病急救医学,2004,16(12):705-707. 被引量:107
  • 10和雪梅.连续性血液滤过治疗重症急性胰腺炎22例[J].中国医学创新,2013,10(12):99-100. 被引量:2

二级参考文献14

  • 1崔乃强,吴咸中.重症急性胰腺炎治疗的现况和展望[J].中国危重病急救医学,2004,16(12):705-707. 被引量:107
  • 2Riedemann N C,Reward P A.Novel strategies for the treatment of sepsis[J].NatMed,2003,9(5):517-524.
  • 3Bernard G R,Vincent J L,Laterre P F,et al.Efficacy and safety of recombinant human activated p rotein C for severe sep sis[J].N Engl J M ed,2001,344 (10):6992-6999.
  • 4Annane D,Aegerter P,Guincestre M C,et al.Current ep idemi2 ology of septic shock:the CUB2Rea Network[J].Am J Respir Crit CareMed,2003,168 (2):16521-16572.
  • 5Surviving Sepsis Campaign:international guidelines for management of severe sepsis and septic shock:2008[J].Crit Care Med,2008,36(1):296-327.
  • 6Canepari G,Inquaqqiato P,Giqliola G,et al.Continuous renal replacement therapies (CRRT)[J].GItal Nefrol,2006,23 (36):30.
  • 7Ullrich R,Rocder G,Lorber C,et al.Continuous venovenous hemofiltration improves arterial oxygenation in endotoxin-induced lung injury in pigs[J].Anesthesiology,2001,95(2):428-436.
  • 8Yekehas E F, Treede H, Knoefel W T,et al.Influence ofzerobalanced hemofiltration on the course of severe experimentalpancreatitis in pigs[J].Ann Surg, 1999, 229: 514522.
  • 9Honore P M, Jamez J, Wauthier M, et al.Prospective evaluation ofshortterm, highvolume isovolemic hemofiltration on the hemodynamiccourse and outcome in patients with intractable circulatory failureresulting from septic shock[J].Crit Care Med, 2000, 28: 3581-3587.
  • 10季大玺,谢红浪,刘芸,任冰,龚德华,张素琴.连续性肾脏替代治疗在重症急性肾功能衰竭救治中的应用[J].肾脏病与透析肾移植杂志,1997,6(5):415-421. 被引量:115

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