持续血液净化可改善多器官功能障碍综合征患者的临床症状并纠正其血浆磷脂水平。
Continuous blood purification ameliorates clinical signs and corrects the plasma phospholipid levels of patients with multiple organ dysfunction syndromes.
作者信息
Wen Wei, Wang Kun, Jiang Zhi-Ming, Zhang Zhong-Hui, Zhou Lei
机构信息
Department of Intensive Care Unit, Shandong Provincial Qianfoshan Hospital, Jinan, China.
Department of Business Management, Shandong Center for Disease Control and Prevention, Jinan, China.
出版信息
J Clin Lab Anal. 2018 Jul;32(6):e22411. doi: 10.1002/jcla.22411. Epub 2018 Feb 18.
BACKGROUND
Multiple organ dysfunction syndromes (MODS) is reported as a leading cause of mortality in intensive care units. Recently, continuous blood purification (CBP) has been mostly applied for MODS treatment. Thus, the purpose of this study was to investigate the effects of CBP on plasma phospholipid level in patients with MODS.
METHODS
A total of 126 patients with MODS and 120 healthy people were collected. The serum cytokine levels, blood biochemical parameters, and blood gas indexes were detected, and the correlation among phospholipid compounds with serum cytokine levels, blood biochemical parameters, and blood gas indexes was analyzed.
RESULTS
Before CBP, levels of body temperature, RR, HR, CVP, IL-6, IL-10, TNF-α, BUN, SCr, PaCO , SM747, and LPC540 were obviously higher, and pH, HCO , PaO , SaO , PE750, PI885, PC792, PC826, PC830, PC854, PC802, and PG747 were lower in the MODS group than those in the control group. During CBP, the MODS group had gradually declined RR, CVP, levels of IL-6, IL-10 and TNF-α, BUN, SCr, PaCO , SM747, and LPC540 and increased HCO , PaO and SaO , PE750, PI885, PC792, PC826, PC830, PC854, PC802, and PG747. Besides, levels of PE750, PI885, PC792, PC826, PC830, PC854, PC802, and PG747 had an obvious negative correlation with levels of TNF-α, IL-10, IL-6, BUN, SCr, and PaCO , and a significant positive correlation with levels of HCO , PaO , and SaO .
CONCLUSION
CBP could effectively ameliorate clinical signs of patients with MODS and correct the plasma phospholipid levels.
背景
多器官功能障碍综合征（MODS）据报道是重症监护病房患者死亡的主要原因。最近，持续血液净化（CBP）已大多应用于MODS的治疗。因此，本研究的目的是探讨CBP对MODS患者血浆磷脂水平的影响。
方法
共收集126例MODS患者和120例健康人。检测血清细胞因子水平、血液生化参数和血气指标，并分析磷脂化合物与血清细胞因子水平、血液生化参数和血气指标之间的相关性。
结果
CBP治疗前，MODS组的体温、呼吸频率（RR）、心率（HR）、中心静脉压（CVP）、白细胞介素-6（IL-6）、白细胞介素-10（IL-10）、肿瘤坏死因子-α（TNF-α）、血尿素氮（BUN）、血肌酐（SCr）、动脉血二氧化碳分压（PaCO₂）、SM747和溶血磷脂酰胆碱540（LPC540）水平明显较高，而pH值、碳酸氢根（HCO₃⁻）、动脉血氧分压（PaO₂）、动脉血氧饱和度（SaO₂）、PE750、PI885、磷脂酰胆碱792（PC792）、磷脂酰胆碱826（PC826）、磷脂酰胆碱830（PC830）、磷脂酰胆碱854（PC854）、磷脂酰胆碱802（PC802）和磷脂酰甘油747（PG747）水平低于对照组。在CBP治疗期间，MODS组的RR、CVP、IL-6、IL-10和TNF-α、BUN、SCr、PaCO₂、SM747和LPC540水平逐渐下降，而HCO₃⁻、PaO₂和SaO₂、PE750、PI885、PC792、PC826、PC830、PC854、PC802和PG747水平升高。此外，PE750、PI885、PC792、PC826、PC830、PC854、PC802和PG747水平与TNF-α、IL-10、IL-6、BUN、SCr和PaCO₂水平呈明显负相关，与HCO₃⁻、PaO₂和SaO₂水平呈显著正相关。
结论
CBP可有效改善MODS患者的临床症状并纠正血浆磷脂水平。
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