连续性血浆吸附联合血浆滤过治疗对脓毒症急性肾损伤患者免疫功能及预后的影响

doi:10.3969/j.issn.1006-6233.2017.08.042

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Abstract Objective: To investigate the effect continuous plasma adsorption combined with plasma filtration therapy on immune function and prognosis of patients with acute renal injuryinduced by sepsis. Methods: A total of 64 patients with acute renal injury were randomly divided into treatment group and control group, 32 cases each. All the patients were treated with anti infection, mechanical ventilation, liquid resuscitation, blood glucose control, correct acidosis and electrolyte disturbance, nutritional support. The control group was treated with continuous renal replacement therapy (CRRT), and the treatment group was treated with continuous plasma filtration (CPFA), the levels of serum inflammatory factors, immune function, biochemical indexes and the 30 survival rate and ICU stay time were compared between the two groups. Results: Before treatment, the immune function of two groups of patients with serum levels of inflammatory factors, and biochemical indexes such as the level of comparison, the difference was not statistically significant (P>0.05).After treatment, two groups of patients with serum hs-CRP, IL-6, IL-1 and TNF- levels were significantly decreased (P < 0.05);Serum IgG, IgA, IgM levels were significantly higher in the experimental group, the level of CD4⁺ increased obviously, the level of CD8⁺ was significantly decreased (P < 0.05);Serum WBC, urea, creatinine levels decreased, patients in the experimental group PLT and N levels than before treatment significantly (P < 0.05)。Comparison between groups of patients in the experimental group, serum hs-CRP, IL-6, IL-1 and TNF- levels significantly lower than the control group (P < 0.05);Serum IgG, IgA, IgM levels significantly higher than the control group (P < 0.05);Serum WBC, urea, creatinine level was significantly lower than that of the control group (P < 0.05)。The control group of 30 patients with D survival rate was 62.50% (20/32) lower than the experimental group 30 d survival rate was 84.38% (27/32) (P>0. 05), ICU residence time (15.31 + 2.21) d was significantly higher than the patients in the experimental group ICU retention time (11.22 + 2.84) d (P < 0.05). Conclusions: Continuous plasma filtration adsorption combined with plasma has good clinical curative effect on acute kidney injury and sepsis, it can significantly improve the immune function of patients, reduce serum inflammatory factors, improve the prognosis, has better clinical significance.

Key words： Continuous plasma adsorption combined with plasma filtration Sepsis Acute kidney injury Immune function

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2017.08.042 OR http://www.hbyxzzs.cn/EN/Y2017/V23/I8/1378

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