Saotome Takao, Endo Yoshihiro, Sasaki Teiji, Tabata Takahisa, Hamamoto Tetsu, Fujino Kazunori, Andoh Akira, Eguchi Yutaka, Tani Tohru, Fujiyama Yoshihide
Critical and Intensive Care Medicine, Shiga University of Medical Science, Shiga, Japan.
Ther Apher Dial. 2005 Aug;9(4):367-71. doi: 10.1111/j.1744-9987.2005.00299.x.
Severe acute pancreatitis is a clinical entity that can develop into multiple organ failure (MOF), and still has a poor prognosis. It is generally agreed that excessive humoral mediators such as pro-inflammatory cytokines play important roles in the pathogenesis of organ failure in patients with severe acute pancreatitis (SAP). Furthermore, it has been reported that continuous hemodiafiltration (CHDF) can remove the excess humoral mediators during the hypercytokinemic state of systemic inflammatory response syndrome (SIRS). We experienced a case of severe acute pancreatitis induced by alcohol abuse, on whom we performed cytokine apheresis. The patient was a 46 year-old male. He received 14 cytokine apheresis procedures, for about 4 hours in each session, using a CTR-001 direct hemoperfusion (DHP) cartridge. His serum levels of pro-inflammatory cytokines such as interleukin-6 (IL-6; 1649.1+/-667.1-1257.1+/-489.4 pg/mL, P=0.013) decreased significantly after the CTR-001 procedures. However tumor necrosis factor-alpha (TNF-alpha) (26.2+/-1.7-24.3+/-1.9 pg/mL, P=0.087), IL-1beta (6.1+/-2.9-3.49+/-1.1 pg/mL, P=0.477), IL-8 (192.5+/-33.4-229.5+/-51.8 pg/mL, P=0.754) and IL-10 (14.4+/-2.7-14.0+/-1.9 pg/mL, P=0.726) did not decrease statistically. Therefore, we conclude that in this case, cytokine apheresis using a CTR-001 cartridge was effective for reducing the pro-inflammatory cytokines during severe acute pancreatitis.
重症急性胰腺炎是一种可能发展为多器官功能衰竭（MOF）的临床病症，且预后仍然较差。人们普遍认为，诸如促炎细胞因子等过多的体液介质在重症急性胰腺炎（SAP）患者的器官功能衰竭发病机制中起重要作用。此外，据报道，持续血液透析滤过（CHDF）可在全身炎症反应综合征（SIRS）的高细胞因子血症状态期间清除多余的体液介质。我们遇到了一例因酗酒诱发的重症急性胰腺炎病例，并对其进行了细胞因子吸附治疗。该患者为一名46岁男性。他接受了14次细胞因子吸附治疗，每次治疗约4小时，使用的是CTR - 001直接血液灌流（DHP）柱。在进行CTR - 001治疗后，他血清中的促炎细胞因子如白细胞介素 - 6（IL - 6；1649.1±667.1 - 1257.1±489.4 pg/mL，P = 0.013）显著下降。然而，肿瘤坏死因子 - α（TNF - α）（26.2±1.7 - 24.3±1.9 pg/mL，P = 0.087）、白细胞介素 - 1β（IL - 1β）（6.1±2.9 - 3.49±1.1 pg/mL，P = 0.477）、白细胞介素 - 8（IL - 8）（192.5±33.4 - 229.5±51.8 pg/mL，P = 0.754）和白细胞介素 - 10（IL - 10）（14.4±2.7 - 14.0±1.9 pg/mL，P = 0.726）并未出现统计学意义上的下降。因此，我们得出结论，在该病例中，使用CTR - 001柱进行细胞因子吸附治疗对于在重症急性胰腺炎期间降低促炎细胞因子是有效的。
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