| 张红伟,胡金涛,徐 放,于占彪,韩丹丹.CRRT治疗剂量对脓毒症休克合并急性肾损伤患者免疫功能及预后的影响[J].,2019,19(15):2937-2940 |
| CRRT治疗剂量对脓毒症休克合并急性肾损伤患者免疫功能及预后的影响 |
| Effect of CRRT Treatment Dose on Immune Function and Prognosis in Patients with Septic Shock Complicated with Acute Kidney Injury |
| 投稿时间：2018-12-08 修订日期：2018-12-31 |
| DOI：10.13241/j.cnki.pmb.2019.15.031 |
| 中文关键词: CRRT 脓毒症休克合并急性肾损伤 免疫功能 肾功能 预后 |
| 英文关键词: CRRT Septic shock combined with acute kidney injury Immune function Renal function Prognosis |
| 基金项目:保定市科技计划项目(18ZF050) |
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| 中文摘要: |
| 摘要 目的：探讨 连续性肾脏替代治疗(Continuous renal replacement therapy，CRRT)治疗剂量对脓毒症休克合并急性肾损伤(acute kidney injury，AKI)患者免疫功能及预后的影响。方法：选择2016年3月到2017年12月我院ICU科收治的脓毒症休克合并急性肾损伤(AKI)患者120例，随机分为高剂量组、中剂量组、低剂量组和对照组四组，每组各30例。对照组采用常规治疗，低剂量组采用20 mL/kg CRRT治疗，中剂量组采用35 mL/kg CRRT治疗，高剂量组采用60 mL/kg CRRT治疗。比较4组治疗前后肾功能、免疫功能指标、APACHEⅡ(Acute Physiology and Chronic Health EvaluationⅡ, APACHEⅡ)评分和SOFA(sequential organ failure assessment)评分分数的变化。结果：治疗后，各组患者血尿素氮(blood urea nitrogen，BUN)和血肌酐(Serum creatinine，Scr)水平、APACHEⅡ评分和SOFA评分均较治疗前显著降低(P<0.05)，且高剂量组BUN、Scr、APACHEⅡ评分和SOFA评分均显著低于其他3组(P<0.05)，中剂量组和低剂量组以上指标均显著低于对照组(P<0.05)，而低剂量组BUN和Scr明显低于对照组(P<0.05)。治疗后，各组患者CD3+、CD4+百分比及CD4+/CD8+比值均较治疗前显著升高(P<0.05)，且高剂量组CD3+、CD4+百分比及CD4+/CD8+比值高于其他3组(P<0.05)，中剂量组以上指标显著高于低剂量组和对照组(P<0.05)，低剂量组以上指标明显高于对照组(P<0.05)。结论：连续性肾脏替代治疗能显著改善脓毒症合并急性肾损伤患者肾功能和免疫功能，且效果呈一定的剂量依赖性。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of continuous renal replacement therapy(CRRT) treatment dose on immune function and prognosis in patients with septic shock and acute kidney injury (AKI). Methods: 120 patients with septic shock and acute kidney injury (AKI) admitted to our hospital from March 2016 to December 2017 were randomly divided into high-dose group, middle-dose group, low-dose group and control group, with 30 cases in each group.The control group received routine treatment, while the small dose group was treated with 20 mL/kg CRRT. The medium dose group was treated with 35 mL/kg CRRT, while the high-dose group was treated with 60 mL/kg CRRT. The renal function, immune function index, acute Physiology and Chronic Health EvaluationⅡ(APACHE II) score and sequential organ failure assessment(SOFA) score were compared between the 4 groups before and after treatment. Results: After treatment, the renal function indexes blood urea nitrogen(BUN) and Serum creatinine(Scr), APACHE II score and SOFA score were significantly lower in each group(P<0.05). After treatment, BUN and Scr, APACHE II score and SOFA score of the high dose group were lower than the other three groups. BUN and Scr, APACHE II score and SOFA score in the middle dose group and the low dose group were lower than in the control group, and BUN and Scr in the low dose group were lower than those in the control group (P<0.05). After treatment, the immune function indexes CD3+, CD4+ percentage and CD4+/CD8+ ratio were significantly increased in each group (P<0.05). The ratio of CD3+, CD4+ percentage and CD4+/CD8+ ratio in the high-dose group were higher than that in the other three groups. The middle-dose group were higher than the low-dose group and the control group, and the low-dose group were higher than the control group. The difference was statistically significant (P<0.05). Conclusion: CRRT can significantly improve the renal function and immune function of patients with sepsis and acute kidney injury, which can contribute to the recovery of patients' condition, and the high-dose group is better than the middle-dose and the low-dose. |
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