血液透析滤过联合 HA330-II 灌流器对感染性休克合并急性肾损伤患者清除炎症因子及预后的影响。

Removal of inflammatory factors and prognosis of patients with septic shock complicated with acute kidney injury by hemodiafiltration combined with HA330-II hemoperfusion.

机构信息

Department of ICU, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.

Department of Urology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.

出版信息

Ther Apher Dial. 2024 Jun;28(3):460-466. doi: 10.1111/1744-9987.14108. Epub 2024 Feb 5.

DOI:10.1111/1744-9987.14108

PMID:38317412

Abstract

INTRODUCTION

To explore the effect of CRRT using CVVHDF + HP on the removal of inflammatory mediators in patients with septic shock complicated with AKI.

METHODS

A total of 20 patients between January 1, 2018, and December 31, 2021, were included. The patients were randomly divided into the treatment group (CVVHDF + HP) and the control group (CVVHDF). Changes in inflammatory factors, including IL-1β, IL-6, IL-8, TNF-α, PCT, and CRP were compared. Other observed measures were also analyzed, for example, Lac, Scr, BUN, SOFA, and norepinephrine (NE) dosage. The clinical outcomes of both groups were followed up for 28 days.

RESULTS

The IL-6 and PCT levels in the treatment group were significantly lower (p = 0.005, 0.007). Although the IL-1β, TNFα, and CRP levels in the treatment group decreased, there were no statistical differences (p > 0.05). There were significant differences in Lac, SOFA, and NE dosage levels between both groups (p = 0.023, 0.01, 0.023). Survival analysis showed that the 28-day survival rate was significantly higher in the treatment group.

CONCLUSION

CRRT using CVVHDF+HP can effectively remove inflammatory factors and improve the prognosis of patients.

摘要

简介

探讨连续性肾脏替代治疗（CRRT）采用 CVVHDF+HP 对感染性休克合并 AKI 患者清除炎症介质的效果。

方法

选取 2018 年 1 月 1 日至 2021 年 12 月 31 日期间的 20 名患者。将患者随机分为治疗组（CVVHDF+HP）和对照组（CVVHDF）。比较两组患者的炎症因子（IL-1β、IL-6、IL-8、TNF-α、PCT 和 CRP）变化。分析其他观察指标，如 Lac、Scr、BUN、SOFA 和去甲肾上腺素（NE）剂量。对两组患者的临床结局进行了 28 天的随访。

结果

治疗组的 IL-6 和 PCT 水平明显降低（p=0.005、0.007）。虽然治疗组的 IL-1β、TNFα和 CRP 水平有所下降，但无统计学差异（p>0.05）。两组 Lac、SOFA 和 NE 剂量水平差异有统计学意义（p=0.023、0.01、0.023）。生存分析显示，治疗组的 28 天生存率明显更高。