Wang Heng-Jin, Wang Pei, Li Nan, Wan Cheng, Jiang Chun-Ming, He Jing-Song, Wang Dong-Jin, Zhang Miao, Sun Ling-Yun
Department of Nephrology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.
Nanjing Drum Tower Hospital, Nanjing Medical University (Nanjing University of Chinese Medicine), Nanjing, China.
Oncotarget. 2017 Feb 7;8(6):10628-10636. doi: 10.18632/oncotarget.13254.
The aim of our study was to evaluate the effect of continuous renal replacement therapy (CRRT) on serum cytokines, neutrophil gelatinase-associated lipocalin (NGAL), and prognosis in patients with severe acute kidney injury (AKI) following cardiac surgery. A total number of 153 patients with severe AKI following cardiac surgery were treated with CRRT. They were divided into the survival and non-survival groups. Clinical data from these two groups before and after CRRT were recorded and analyzed. It was found that the number of impaired organs, MODS and APACHE II scores were significantly higher in the non-survival group than those in the survival group before CRRT. After CRRT, MODS and APACHE II scores decreased significantly. The post-CRRT levels of serum TNF-α and IL-6 were significantly decreased. After CRRT, serum NGAL decreased in the two groups, but the levels were higher in the non-survival group than those in the survival group. MODS and APACHE II scores could be used to evaluate the severity of AKI in patients after cardiac surgery. CRRT is an effective treatment for these patients and high levels of TNF-α, IL-6, and NGAL are associated with a poor prognosis in these patients.
我们研究的目的是评估连续性肾脏替代疗法(CRRT)对心脏手术后严重急性肾损伤(AKI)患者血清细胞因子、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)及预后的影响。共有153例心脏手术后发生严重AKI的患者接受了CRRT治疗。他们被分为存活组和非存活组。记录并分析了这两组患者在CRRT治疗前后的临床资料。结果发现,在CRRT治疗前,非存活组的器官功能障碍数量、多器官功能障碍综合征(MODS)及急性生理与慢性健康状况评分系统II(APACHE II)评分显著高于存活组。CRRT治疗后,MODS及APACHE II评分显著降低。CRRT治疗后血清肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平显著下降。CRRT治疗后,两组患者的血清NGAL均下降,但非存活组的水平高于存活组。MODS及APACHE II评分可用于评估心脏手术后患者AKI的严重程度。CRRT是治疗这些患者的有效方法,高水平的TNF-α、IL-6及NGAL与这些患者的不良预后相关。