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连续性肾脏替代治疗对脓毒症相关性急性肾损伤患者症状、炎症介质和凝血功能的疗效。

Treatment Efficacy of Continuous Renal Replacement on Symptoms, Inflammatory Mediators, and Coagulation Function in Patients with Sepsis-Associated Acute Kidney Injury.

机构信息

Department of Nephrology, First Affiliated Hospital of Gannan Medical University, 341000 Ganzhou, Jiangxi, China.

出版信息

Arch Esp Urol. 2022 Nov;75(9):746-752. doi: 10.56434/j.arch.esp.urol.20227509.109.

DOI:10.56434/j.arch.esp.urol.20227509.109
PMID:36472056
Abstract

INTRODUCTION

The aim of this study is to compare the treatment efficacy between continuous renal replacement therapy (CRRT) and conventional intermittent hemodialysis (IHD) in patients with sepsis (SIRS) combined with acute kidney injury (AKI) and its impact on inflammatory mediators and coagulation function.

METHOD

122 patients (25-60 years) with SIRS combined with AKI were enrolled in the sudy. The study group (SG) comprised 62 patients who received CRRT (8-10 h/day) + routine treatment, whereas the control group (CG) comprised 60 patients who received conventional IHD (4 h/day, 3 times per week) + routine treatment. inflammatory mediators and coagulation function measures were assessed and compared in each group.

RESULTS

C-reactive protein, blood creatinine, blood urea nitrogen, blood lactic acid, oxygenation index, central venous oxygen saturation, SOFA (Sequential Organ Failure Assessment) score, interleukin 6, interleukin 8, hypersensitive C-reactive protein, tumor necrosis factor-α, prothrombin time, activated partial thromboplastin time, FIB, and platelet count were better in the SG than in the CG ( < 0.05). The 12- and 24-month survival rates were significantly higher in the SG than in the CG ( < 0.05).

CONCLUSIONS

CRRT can effectively improve clinical symptoms, remove inflammatory factors, and maintain blood coagulation function in patients with SIRS combined with AKI. It is more efficient than IHD treatment and is worthy of clinical promotion.

摘要

简介

本研究旨在比较连续性肾脏替代疗法(CRRT)与常规间歇性血液透析(IHD)在脓毒症(SIRS)合并急性肾损伤(AKI)患者中的治疗效果及其对炎症介质和凝血功能的影响。

方法

本研究纳入了 122 名(25-60 岁)SIRS 合并 AKI 患者。研究组(SG)包括 62 例接受 CRRT(8-10 小时/天)+常规治疗的患者,对照组(CG)包括 60 例接受常规 IHD(4 小时/天,每周 3 次)+常规治疗的患者。评估并比较了每组患者的炎症介质和凝血功能指标。

结果

SG 组的 C 反应蛋白、血肌酐、血尿素氮、血乳酸、氧合指数、中心静脉血氧饱和度、SOFA(序贯器官衰竭评估)评分、白细胞介素 6、白细胞介素 8、超敏 C 反应蛋白、肿瘤坏死因子-α、凝血酶原时间、活化部分凝血活酶时间、纤维蛋白原和血小板计数均优于 CG 组(<0.05)。SG 组的 12 个月和 24 个月生存率均明显高于 CG 组(<0.05)。

结论

CRRT 可有效改善 SIRS 合并 AKI 患者的临床症状,清除炎症因子,维持凝血功能,其疗效优于 IHD 治疗,值得临床推广。

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