Shiga Hidetoshi, Hirasawa Hiroyuki, Nishida Osamu, Oda Shigeto, Nakamura Masataka, Mashiko Kunihiro, Matsuda Kenich, Kitamura Nobuya, Kikuchi Yoshihiko, Fuke Nobuo
Emergency and Intensive Care Center, Teikyo University Chiba Medical Center, Chiba, Japan.
Blood Purif. 2014;38(3-4):211-8. doi: 10.1159/000369377. Epub 2014 Dec 19.
BACKGROUND/AIM: We investigated the clinical efficacy of continuous hemodiafiltration (CHDF) with AN69ST hemofilter (AN69ST-CHDF) in patients with septic shock.
A prospective, multicenter, single-arm study was conducted. Patients with sepsis and shock defined by hyperlactemia were enrolled. The patients were treated with CHDF and in accordance with the Surviving Sepsis Campaign guidelines (SSCG).
Thirty-four patients were enrolled. On ICU admission, the mean blood IL-6 level was 44,800 ± 77,700 pg/ml, and the mean blood lactate level was 69.0 ± 49.4 mg/dl. Both the mean blood IL-6 and lactate levels had significantly decreased to normal ranges after 72 h of AN69ST-CHDF. Though the mean APACHE II score was 32.7 ± 9.8, 28-day survival was 73.5%.
The current study suggested that adding AN69ST-CHDF to the treatments outlined in the SSCG might lead to good outcomes for patients with septic shock, probably via the removal of cytokines from the bloodstream.
背景/目的：我们研究了使用AN69ST血液滤过器进行持续血液透析滤过（CHDF，即AN69ST-CHDF）治疗感染性休克患者的临床疗效。
开展了一项前瞻性、多中心、单臂研究。纳入因高乳酸血症定义的脓毒症和休克患者。患者接受CHDF治疗，并遵循拯救脓毒症运动指南（SSCG）。
共纳入34例患者。入住重症监护病房（ICU）时，血液白细胞介素-6（IL-6）平均水平为44,800±77,700 pg/ml，血液乳酸平均水平为69.0±49.4 mg/dl。经过72小时的AN69ST-CHDF治疗后，血液IL-6和乳酸平均水平均显著降至正常范围。尽管急性生理与慢性健康状况评分系统（APACHE）II平均评分为32.7±9.8，但28天生存率为73.5%。
当前研究表明，在SSCG概述的治疗方案中加入AN69ST-CHDF可能会使感染性休克患者获得良好预后，可能是通过清除血液中的细胞因子实现的。
