静脉-静脉血液滤过对MODS患者外周血细胞因子的影响

    Influence of veno-venous hemofiltration on plasma cytokines in patiens with multiple organ dysfunction syndrome

    • 摘要: 目的: 探讨静脉-静脉血液滤过透析(VVHDF)技术对多器官功能障碍综合征(MODS)患者外周血细胞因子的影响。方法: 55例MODS患者经股静脉留置单针双腔导管,使用Hospal BSM 22 SC血滤系统行床边VVHDF治疗。检测VVHDF治疗前后血浆BUN、Cr、K+的浓度,并检测动脉血pH值、HCO3-;在治疗前和治疗后1、3、6、24h分别取静脉血,采用ELISA法测定血浆TNF-α、IL-1、IL-6、IL-8、IL-10含量。结果: 所有患者在VVHDF治疗后血BUN、Cr、K+均明显下降,HCO3-升高(P<0。001),酸中毒得到改善。血浆IL-1、IL-8、IL-10水平明显下降(P<0。01),而血浆IL-6水平在治疗后1h时均低于治疗前和治疗后24h (P<0。05),TNF-α水平在VVHDF前后差异无显著性(P>0。05)。结论: VVHDF能改善MODS患者血生化指标,可以用于MODS的治疗,同时可清除血浆中部分细胞因子。

       

      Abstract: Objective: To explore the influence of veno-venous hemodiafiltration(VVHDF) on plasma cytokines in patiens with multiple organ dysfunction syndrome(MODS).Methods: A double lemen catheter was put into the femoral vein of 55 patiens with MODS,and the VVHDF was performed with the Hospal BSM 22 SC.The level of serum BUN,Cr,K+ and arterial blood gas was measured before and after VVHDF,and the plasma TNF-α,IL-1,IL-6,IL-8,IL-10 was measured by ELISA at 0,1,3,6,24 hours after VVHDF. Results: The level of serum BUN,Cr,K+ decresed significantly,HCO3-in creased,after VVHDF(P<0.001),The plasma concentration of IL-1,IL-8 and IL-10 decreased significantly(P<0.01),The plasma concentration of IL-6 was lower at 1 hours after VVHDF than before VVHDF and 24 hours after VVHDF.There was no significant difference in the plasma concentration of TNF-α at any time before and after VVHDF(P>0.05).Conclusions: VVHDF can improve the blood biochemical markers of the patients with MODS and remove some cytokines in plasma.

       

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