摘要
目的探讨血浆置换(PE)联合血液透析滤过(CHD)治疗重症胰腺炎(severe acute pancreatitis、SAP)的临床疗效。方法将62例SAP患者随机分为治疗组(A组)和对照组(B组),A组32例采用内科综合治疗+PE+CHD治疗;B组30例采用内科综合治疗。观察治疗前后临床症状体征及白细胞(WBC)、纤维蛋白酶原(Fib)、血淀粉酶(LDH)、血糖(Glu)、肝肾功能、内毒素(LPS)、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、白细胞介素8(IL-8)结果。结果两组在临床症状体征改善、食欲好转方面差异无统计学意义(P>0.05);两组患者WBC、LDH、Glu和ALT在治疗后7天均有不同程度的降低,Fib升高,其中治疗组更明显,差异有统计学意义(P<0.01);Cr在A组明显降低,在B组明显升高,但差异无统计学意义(P>0.05);A组治疗后LDH低于B组(185.12±45.02)U/L vs(264.31±39.42)U/L(P<0.01)。两组治疗后血清LPS、TNF-α、IL-6、IL-8水平均明显下降,与治疗前比较差异有统计学意义(均P<0.01)。两组间治疗后IL-6、IL-8比较差异有统计学意义(P<0.01)。结论 PE联合CHD治疗SAP能迅速改善临床症状体征,显著降低WBC、LDH、Glu、LPS、TNF-α、IL-6、IL-8水平,升高血清Fib,提高患者存活率。
Objective To explore the effect of plasma exchange（PE） joint hemodialysis（HDF） treatment for severe acute pancreatitis（SAP）.Methods 62 cases were randomly divided into treatment group（A group） and control group（B group）,32 patients in A group got medical treatment ＋ PE ＋ HDF treatment,30 cases in control group comprehensive internal medicine treatment.Clinical symptoms were observed before and after treatment and routine blood（WBC）,blood amylase,protease,fiber LDH,fiber protease original（Fib）,blood sugar（Glu）,endotoxin（LPS）,tumor necrosis factor alpha（TNF-α） and interleukin（IL-6） and interleukin（IL-8） were detected.Results Two groups showed no statistical significance in the clinical symptoms and signs in treatment（P0.05）,WBC,LDH and Glu in 7 days after treatment decreased in different degrees,but Fib increased,in treatment group they were apparent with statistic significance（P0.01）,ALT,Cr declined,but the differences were not statistically significant（P0.05）.LDH in A group after treatment was lower than that in B group（185.12±45.02） U/L vs（264.31±39.42） U/L（P0.01）.After treatment,LPS,TNF alpha,IL-6,IL-8 levels were obviously decreased in both groups（P 0.01）.After treatment,the comparisons of IL-6,IL-8 between two groups were statistically significant（P0.01）.Conclusion PE joint CHD treatment can rapidly improve the clinical symptoms and signs of SAP,significantly reduce WBC and LDH,Glu LPS,TNF-α,IL-6,IL-8 level,raise Fib,improve the survival rate of the patients.
出处
《临床荟萃》
CAS
2011年第9期760-762,765,共4页
Clinical Focus
关键词
胰腺炎
血浆置换
肾透析
pancreatitis
plasma exchange
renal dialysis
