Chen Guang-Ming, Lan Yu-Ying, Wang Cheng-Feng, Zhan Hai-Xia, Wang Wen-Rui, Chen Jin-Hua, Chen Jian
Department of Pediatrics, Fuzhou General Hospital of Nanjing Military Command, PLA, Clinical Medical College of Fujian Medical University in Fuzhou General Hospital of Nanjing Military Command, PLA, Dongfang Hospital Affiliated to Xiamen University, NO, 156, Xi Er-Huan North Road, Fuzhou 350025, Fujian Province, China.
Scand J Trauma Resusc Emerg Med. 2014 Aug 22;22:49. doi: 10.1186/s13049-014-0049-z.
We have previously reported that hemofiltration (HF) may be an effective additional means of treating heat stroke when rapid cooling is not effective.
Dogs were assigned to a heat stroke (control) or heat stroke + hemofiltration (HF) group (n = 8 each group). After heat stroke induction, dogs in the HF group received HF for 3 h. Serum concentrations of interleukin (IL)-10, tumor necrosis factor (TNF)-α, IL-6, blood urea nitrogen (BUN) and creatinine were measured at baseline and 1, 2, and 3 h after heat stroke. Clearance rates of solutes were determined 1, 2, and 3 h after the start of HF.
Serum concentrations of all solutes tended to increase with time after heat stroke in the control group, but decreased (BUN, creatinine) or remained relatively unchanged (TNF-α, IL-6, IL-10) with time in the HF group. Concentrations of all solutes were significantly lower in the HF group compared with the control group at 2 and 3 h (P < 0.05). Clearance rates for small molecular weight solutes were high, while those for larger molecular weight solutes were low.
HF prevents heat stroke-induced increases in serum cytokine concentrations and is effective for clearing small molecular weight solutes from serum, but less effective for clearing larger molecular weight solutes, including TNF-α, IL-6, and IL-10.
我们之前曾报道，当快速降温无效时，血液滤过（HF）可能是治疗中暑的一种有效辅助手段。
将犬分为中暑（对照组）或中暑+血液滤过（HF）组（每组n = 8）。诱导中暑后，HF组的犬接受3小时的血液滤过治疗。在基线以及中暑后1、2和3小时测量血清白细胞介素（IL）-10、肿瘤坏死因子（TNF）-α、IL-6、血尿素氮（BUN）和肌酐的浓度。在血液滤过开始后1、2和3小时测定溶质清除率。
对照组中暑后血清中所有溶质的浓度均随时间呈上升趋势，而HF组中这些溶质的浓度随时间下降（BUN、肌酐）或保持相对不变（TNF-α、IL-6、IL-10）。在2小时和3小时时，HF组中所有溶质的浓度均显著低于对照组（P < 0.05）。小分子质量溶质的清除率较高，而大分子质量溶质的清除率较低。
血液滤过可防止中暑引起的血清细胞因子浓度升高，对清除血清中的小分子质量溶质有效，但对清除包括TNF-α、IL-6和IL-10在内的大分子质量溶质效果较差。
