中国血液净化

中国血液净化 ›› 2024, Vol. 23 ›› Issue (05): 338-341.doi: 10.3969/j.issn.1671-4091.2024.05.004

• 临床研究 • 上一篇    下一篇

血液灌流联合血液滤过对脓毒症炎症介质及预后影响的Meta分析

吴丽红    王林华    罗 莉    史大治   

  1. 130000 长春，1吉林省一汽总医院重症医学科
    130000 长春，2吉林省人民医院肾内科
  • 收稿日期:2023-11-14 修回日期:2024-02-24 出版日期:2024-05-12 发布日期:2024-05-12
  • 通讯作者: 吴丽红 E-mail:22024746@qq.com
  • 基金资助:
    吉林省卫生健康科技能力提升项目(2023LC057)

Meta analysis of the effects of hemoperfusion combined with hemofiltration on inflammatory mediators and prognosis in sepsis

WU Li-hong, WANG Lin-hua, LUO Li, SHI Da-zhi   

  1. ICU, Jilin FAW General Hospital, Changchun 130000, China; 2Department of Nephrology, Jilin Provincial People's Hospital, Changchun 130000, China
  • Received:2023-11-14 Revised:2024-02-24 Online:2024-05-12 Published:2024-05-12
  • Contact: 130000 长春，1吉林省一汽总医院重症医学科 E-mail:22024746@qq.com

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摘要： 目的  通过Meta分析评价血液灌流联合血液滤过对脓毒症炎症介质及预后的影响。 方法  检索PubMed、Web of Science、Medline、中国知网(CNKI)、万方数据库、维普数据库，选取血液灌流联合血液滤过对脓毒症治疗的随机对照试验(观察组采用血液灌流联合血液滤过治疗，对照组采用单纯血液滤过治疗)，检索时间为建库至2023年6月30日。采用RevMan 5.4软件进行Meta分析，采用漏斗图进行偏倚评估。 结果  共纳入19篇文献，1322例患者。Meta分析结果显示：观察组与对照组患者相比C反应蛋白降低(SMD=-1.60，95% CI：-2.02～-1.18，P＜0.001)、肿瘤坏死因子-α水平下降(SMD=-1.60，95% CI：-1.77～-1.43，P＜0.001)、白细胞介素-6水平下降(SMD=-1.29，95% CI：-1.43～-1.14，P＜0.001)、序贯器官衰竭评分降低(SMD=-0.74，95% CI：-0.98～-0.51，P＜0.001)、病死率降低(RR=0.50，95% CI：0.39～0.65，P＜0.001)。 结论  血液灌流联合血液滤过治疗可以下调脓毒症的炎症介质，降低序贯器官衰竭评分及病死率，改善预后。

关键词: 血液灌流, 血液滤过, 脓毒症, 炎症介质

Abstract: Objective  To evaluate the impact of hemoperfusion combined with hemofiltration on inflammatory mediators and prognosis in sepsis through meta-analysis.  Method  A comprehensive literature search was conducted using PubMed, Web of Science, MedLine, China National Knowledge Infrastructure (CNKI), Wanfang Database, and VIP Database to collect randomized controlled trials of blood perfusion combined with blood filtration for the treatment of sepsis (observation group treated with blood perfusion combined with blood filtration, control group treated with pure blood filtration). The search was conducted from the establishment of the database until June 30, 2023. Meta-analysis was conducted by using RevMan 5.4 software, and funnel plots were used to analyze the publication bias of various studies.  Results   A total of 19 articles were included, including 1322 patients. Meta-analysis showed that compared to the control group, the observation group had a lower level of C-reactive protein (SMD=-1.60, 95% CI：-2.02～-1.18, P＜0.001), and a lower level of tumor necrosis factor-α (SMD=-1.60, 95% CI：-1.77～ -1.43, P＜0.001), a lower level of interleukin-6 (SMD=-1.29, 95% CI：-1.43～--1.14, P＜0.001), a lower level of sequential organ failure scores (SMD= -0.74, 95% CI：-0.98, -0.51, P＜0.001), and decreased mortality rates (RR=0.50, 95% CI：0.39～ 0.65, P＜0.001).  Conclusion  The combination of hemoperfusion and hemofiltration therapy can downregulate the inflammatory mediators in sepsis, reduce SOFA scores and mortality, and improve prognosis.

Key words: Hemoperfusion, Hemofiltration, Sepsis, Inflammatory mediators

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