期刊文献+

连续静脉-静脉血液滤过对严重腹腔感染血浆内毒素及细胞因子清除能力研究 被引量:8

Effect of continuous veno-venous hemofiltration on the plasma levels of endotoxin and cytokine in patients with severe intra-abdominal infection
原文传递
导出
摘要 目的研究严重腹腔感染病人行连续静脉-静脉血液滤过(CVVH)治疗前后血浆中内毒素及细胞因子的变化情况,评价CVVH对严重腹腔感染病人血内毒素及细胞因子的清除能力及其影响因素。方法 2010年9月至2011年9月南京军区南京总医院筛选ICU 21例接受CVVH的严重腹腔感染危重病人,观察行CVVH治疗前后72 h血浆中内毒素、TNF-α、IL-10的变化。入组病人分为每24h更换滤器组(10例)和血凝更换滤器组(11例)。结果严重腹腔感染病人行CVVH治疗24h后血浆中内毒素及TNF-α水平明显下降(P<0.05),IL-1048h后明显下降。每24 h置换滤器组内毒素水平在48及72 h维持在较低水平(P<0.05)。结论 CVVH可有效清除严重腹腔感染病人血浆中内毒素和细胞因子TNF-α、IL-10。24 h内更换滤器有益于血浆中内毒素的清除,并将血浆内毒素维持在较低水平。 Objective To investigate the clearance effect of continuous veno-venous hemofiltration(CVVH)on plasma endotoxin and cytokine in patients with severe intra-abdominal infection, and evaluate its clear ability and influence factors on endotoxin and cytokine in patients with severe intra-abdominal infection. Methods Twenty-one patients with severe intra-abdominal infection in ICU were enrolled for the CVVH treatment carried out between September 2010 and September 2011 in Nanjing General Hospital of Nanjing Military Command to observe the plasma changes of endotoxin, TNF-α, IL-10 during the treatment in 72h. The patients were divided into two groups: the filters were replaced every 24h group (n=10) and the control group (n=11). Results Plasma endotoxin and TNF-αdecreased significantly at 24h after CVVH treatment (P〈0.05). Yet, the level of IL-10 began to decrease at 48h after CVVH treatment. The plasma endotoxin maintained on low level at 48h and 72h after CVVH treatment in the observation group compared with the control group(P〈0.05). Conclusion Plasma endotoxin and cytokines (TNF-α, IL-10) can be removed effectively with CVVH in patients with severe intra-abdominal infection. CVVH has a positive effect on accelerate the removal of the plasma endotoxin and maintain a low level when replace the filter every 24 hours.
出处 《中国实用外科杂志》 CSCD 北大核心 2014年第5期444-446,共3页 Chinese Journal of Practical Surgery
关键词 严重腹腔感染 连续静脉静脉血液滤过 内毒素 细胞因子 脓毒症 severe intra-abdominal infection continuous veno-venous hemofiltration endotoxin cytokine sepsis
  • 相关文献

参考文献6

  • 1任建安,黎介寿.严重腹腔感染的综合治疗[J].中国实用外科杂志,2007,27(12):940-942. 被引量:51
  • 2Hagiwara S, Iwasaka H, Hasegawa A, et .Continuous hemodia- filtration therapy ameliorates LPS-induced systemic inflamma- tion in a rat model[J].J Surg Res,2011,171(2): 791-796.
  • 3Cruz DN, Antonelli M, Fumagalli R,et al. Early use of polymyxin B hemoperfusion in abdominal septic shock: the EUPHAS ran- domized controlled trial[ J] .JAMA, 2009,301 (23): 2445-2452.
  • 4Magalh~es PO, Lopes AM, Mazzola PG,et al. Methods of endo- toxin removal from biological preparations: a review [J].J Pharm Pharm Sci, 2007,10(3): 388-404.
  • 5Cruz D, Bellomo R, Kellum JA, et al. The future of extracorpore- al support[J]. Crit Care Med, 2008,36(suppl 4): 243-252.
  • 6黎介寿.腹腔感染与免疫调控[J].中国实用外科杂志,2007,27(12):931-932. 被引量:24

二级参考文献13

  • 1虞文魁,李维勤,王晓东,燕晓雯,祁晓平,李宁,黎介寿.胰岛素严格控制血糖对脓毒症患者的影响及其机理的初步探讨[J].中华外科杂志,2005,43(1):29-32. 被引量:47
  • 2任建安.重症脓毒症和脓毒症休克治疗指南[J].中国实用外科杂志,2005,25(1):37-41. 被引量:34
  • 3任建安,王(?)非,范朝刚,王新波,姜军,汪志明,顾军,黎介寿.肠瘘并发第三类型腹膜炎的治疗[J].中华胃肠外科杂志,2006,9(4):284-286. 被引量:19
  • 4Zanotti S. Cytokine modulation in sepsis and shock [J]. Expert Opin Investing Drugs ,2002,11(8):1061-1075.
  • 5Antonell M. Sepsis and septic shock proinflammatory or anti-inflammatory state [J]. Z J Chemo Ther, 1999,11(3):536-540.
  • 6Pieracci FM, Barie PS. Intraabdominal infections [J].Curr Opin Crit Care,2007,13(4):440-449.
  • 7Sansen JO, Loudon MA. Damage contaol surgery in non-traume setting[J]. Brit J Surg.2007,94(6):789-790.
  • 8Marik PE, Raghavan M. Stresshyper glycemia insulin and in imu- nomodula tiom in sepsis [J]. Int Care Med,2004,30(5):748-756.
  • 9Murata A. Granuloeyte Colony-stimulating factor as the expecting sword for the treatment of severe sepsis [J]. Curr Pham Des, 2003,9(8):1115-1120.
  • 10Raghavan M, Marik PE. Management of sepsis during the early“Golden Hours” [J]. J Emerg Med ,2006,31(1):185-199.

共引文献69

同被引文献84

  • 1付素珍,马骏,孙杰,董云,赵琪,李华.血必净注射液联合血液净化治疗对脓毒血症疗效及免疫调节影响[J].环球中医药,2013,6(S1):93-93. 被引量:11
  • 2王今达,王宝恩.多脏器功能失常综合征(MODS)病情分期诊断及严重程度评分标准(经庐山’95全国危重病急救医学学术会讨论通过)[J].中国危重病急救医学,1995,7(6):346-347. 被引量:1422
  • 3张久聪,董茜,邵彬.胸腺肽α1的作用机制和临床应用[J].细胞与分子免疫学杂志,2006,22(4):547-549. 被引量:55
  • 4Charlotte S. Rearm PCT chiefs fight loss of accountability status and fight to redundancy [J]. Health Serv J, 2011,121 (6243) : 4-5.
  • 5Kawai T, Aaira S. The role of pattern-recognition receptors in innate immunity : Update on Toll-like receptors [ J ]. Nat Immunol, 2010, 11 (5) :373-384.
  • 6Bone RC, Balk RA, Cenla FB, et al. Definitions for sepsis and organ failure an d guidelines for the use of innovative therapies in sepsis the ACCP/SCCM consensus conference committ- ee. American college of chest physiccians/saeiety of critical ca-re medicine [J].Chest, 1992,101 ( 6 ) : 1644-1655.
  • 7Cheng B, Xie G, Yao S, et al. Epidemiology of severe sepsis in critically ill surgical patients in ten university hospitals in China [ J]. Crit Care Med ,2007,35 ( 11 ) :2538-2546.
  • 8Fry DE. Sepsis, systemic inflammatory response, and ml.dtiple organ dysfunction : the mystery continues [ J ]. Am Surg, 2012,75 (1):1-8.
  • 9Peng Y, Chen Z, Yu W, et al. Effects of thymic polypeptides on the thymopoiesis of mouse embryonic stem cells [ J ]. Cell Biol Int ,2008,32 (10) : 1265-1271.
  • 10Garaei E, Favalli C, Pica F, et al. Thymosin alpha 1 : from bench to bedside [ J ]. Ann NY Acad Sci,2007,1112:225-234.

引证文献8

二级引证文献53

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部