Second Division, Department of Internal Medicine, Hamamatsu, Japan.
Blood Purif. 2011;32(2):75-81. doi: 10.1159/000320128. Epub 2011 Mar 2.
Recently, the potential therapeutic effect of direct hemoperfusion with a polymyxin B-immobilized fiber column (PMX-DHP) has been reported for acute exacerbation of interstitial pneumonia (AE-IP), a highly morbid clinical event; however, there is no consensus on the appropriate procedure for PMX-DHP. We examined the appropriate perfusion duration of PMX-DHP for AE-IP.
AE-IP patients receiving PMX-DHP were divided into two groups: short-duration group (≤6 h) (n = 5) and long-duration group (12 h) (n = 12).
ThePaO(2)/FiO(2) (P/F) ratio increased immediately after PMX-DHP in the two groups. In the long-duration group, the P/F ratio continued to increase over the following 7 days, while, in the short-duration group, the P/F ratio declined again 3 days after therapy. The survival rate 30 days after PMX-DHP was significantly higher in the long-duration group than in the short-duration group.
A long perfusion duration of PMX-DHP is more efficacious for AE-IP than a short perfusion duration.
最近,有研究报道多黏菌素 B 固定纤维柱(PMX-DHP)直接血液灌流对间质性肺炎急性加重(AE-IP)有潜在的治疗作用,AE-IP 是一种病死率极高的临床事件;但是,对于 PMX-DHP 的适宜治疗时间尚无共识。我们研究了 PMX-DHP 治疗 AE-IP 的适宜灌流时间。
将接受 PMX-DHP 治疗的 AE-IP 患者分为两组:短时间组(≤6 小时)(n=5)和长时间组(12 小时)(n=12)。
两组患者在 PMX-DHP 治疗后 PaO(2)/FiO(2)(P/F)比值立即升高。在长时间组,P/F 比值在随后的 7 天内持续升高,而在短时间组,治疗后 3 天 P/F 比值再次下降。PMX-DHP 治疗后 30 天的生存率在长时间组显著高于短时间组。
PMX-DHP 的长时间灌流比短时间灌流对 AE-IP 更有效。