Abstract：Objective: To investigate the clinical value of low-dose injection of methylprednisolone sodium succinate combined with continuous renal replacement therapy (CRRT) in the treatment of emergency sepsis. Methods: 70 patients with ICU sepsis in our hospital were enrolled. Patients treated with CRRT therapy + low-dose injection with methylprednisolone sodium succinate were divided into observation groups using simple CRRT. Therapists were divided into control groups, with 35 cases in each group. On the basis of routine and symptomatic treatment, the control group was given CRRT therapy, and the observation group was given CRRT therapy + low-dose injection with methylprednisolone sodium succinate. The treatment conditions were compared between the two groups (APACHE II score, vasoactive substances and antibiotic use after 7 days of treatment). Time, ICU check-in time, serum inflammatory factors [TNF-α, IL-1, procalcitonin (PCT)] levels before and 7 days after treatment Immune function [serum T lymphocyte subsets (CD4+, CD8+) levels], incidence of adverse reactions during treatment, 28-day mortality were counted. Results: (1) Treatment: The APACHE II score was lower in the observation group than in the control group after 7 days of treatment, and the vasoactive substances and antibiotic use time, ICU stay time was shorter than the control group (P<0.05); (2) inflammatory factor: treatment The levels of serum TNF-α, IL-1 and PCT in the post-observation group were lower than those in the control group (P<0.05). (3) Immune function: The levels of CD4+ and CD8+ in serum T lymphocytes were higher in the observation group than in the control group (P<0.05). (4) Safety: During the treatment period, the incidence of adverse reactions in the observation group was 17.14% (6/35) and the control group was 11.43% (4/35). There was no significant difference (P>0.05); (5) Prognosis: observation There was no significant difference between the group's 28-day mortality rate of 25.71% (9/35) and the control group of 37.14% (13/35) (P>0.05). Conclusion: CRRT therapy based on the treatment of patients with acute sepsis with low-dose injection of methylprednisolone sodium succinate is beneficial to delay the progression of the disease and promote early disease outcome, which may be related to its down-regulation of serum inflammatory factor expression and correction of immune disorders. And the safety of the program is guaranteed, but there is no direct data to confirm that it can significantly reduce the mortality rate of sepsis.
王娜. 低剂量注射用甲泼尼龙琥珀酸钠联合CRRT疗法对脓毒血症患者免疫功能水平及预后的影响[J]. 河北医学, 2019, 25(6): 922-926.
WANG Na. Effect of Low-dose Injection of Methylprednisolone Sodium Succinate combined with CRRT on Immune Function and Prognosis in Patients with Acute Sepsis. HeBei Med, 2019, 25(6): 922-926.
2019, Vol. 25 
冀公网安备13080202000677号