中国血液净化

中国血液净化 ›› 2024, Vol. 23 ›› Issue (05): 356-359.doi: 10.3969/j.issn.1671-4091.224.05.008

• 临床研究 • 上一篇    下一篇

不同血液透析滤器对发生急性肿瘤溶解综合征的血液系统肿瘤患者的细胞因子吸附作用：一项单中心回顾性研究

张小攀    沈耀耀    尤 冰    陈广仁    陈凤玲   

  1. 215000 苏州，苏州大学附属第一医院1血液透析中心 2血液科
  • 收稿日期:2023-12-18 修回日期:2024-03-11 出版日期:2024-05-12 发布日期:2024-05-12
  • 通讯作者: 陈凤玲 E-mail:chenfl02513@163.com

The cytokine adsorption effect of different hemodialysis filters in patients with hematological tumors and acute tumor lysis syndrome: a single-center retrospective study

HANG Xiao-pan1, SHEN Yao-yao2, YOU Bing1, CHEN Guang-ren1, CHEN Feng-ling   

  1. Department of Hemodialysis Center, and 2Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215000, China
  • Received:2023-12-18 Revised:2024-03-11 Online:2024-05-12 Published:2024-05-12
  • Contact: 215000 苏州，苏州大学附属第一医院1血液透析中心 E-mail:chenfl02513@163.com

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摘要： 目的  回顾性研究不同血液透析滤器对发生急性肿瘤溶解综合征的血液系统肿瘤患者的细胞因子吸附作用。 方法 回顾性分析2020年9月─2023年9月于苏州大学附属第一医院血液科住院期间发生急性肿瘤溶解综合征并需要联合连续性肾脏替代治疗(continuous renal replacement therapy，CRRT)且临床资料完整的57例患者。依据采用的滤器型号不同分为观察组和对照组。观察组采用甲基丙烯磺酸钠-丙烯腈共聚物(acrylonitrile and sodium methallyl sulfonate copolymer，AN)69-OXIRIS滤器，对照组采用AN69-ST100滤器。 结果 本研究发现2种滤器在肾脏基础替代治疗中的作用基本一致。但观察组与对照组相比，白细胞介素(interleukin，IL)-6(Z=8.937,P＜0.001)、IL-1b(t=2.177,P=0.031)、IL-10(t=4.065,P=0.009)、IL-17A(t=4.382，P=0.013)、干扰素(interferon,IFN)-γ(t=6.812,P =0.002)方面下降，差异具有统计学意义。 结论 在血液系统肿瘤治疗期间发生急性肿瘤溶解综合征的患者中，CRRT时选择AN69-OXIRIS滤器可以更好的吸附细胞因子，有助于改善患者的预后。

关键词: 急性肿瘤溶解综合征, 细胞因子, 血液透析滤器

Abstract: Objective  To retrospectively study the cytokine adsorption effect of different hemodiafiltration filters on patients with hematologic malignancies who developed acute tumor lysis syndrome.  Methods  This article retrospectively analyzed 57 patients who developed acute tumor lysis syndrome and required continuous renal replacement therapy (CRRT) during their hospitalization in the Department of Hematology, The First Affiliated Hospital of Soochow University from September 2020 to September 2023. Patients were divided into an observation group and a control group based on the filter used for CRRT. The observation group used the AN69-OXIRIS filter, while the control group used the AN69-ST100 filter.  Results  The two filters had basically the same effect of renal replacement therapy. Cytokines of IL-6 (Z=8.937, P＜0.001), IL-1b (t=2.177, P=0.031), IL-10 (t=4.065, P=0.009), IL-17A (t=4.382, P=0.013) and interferon-γ (t=6.812, P=0.002) decreased significantly in observation group, as compared with those in control group.  Conclusion   In patients developed acute tumor lysis syndrome during the treatment of hematologic malignancies, the use of the AN69-OXIRIS filter for CRRT will be more effective on cytokine adsorption and prognosis improvement.

Key words: Acute tumor lysis syndrome, Cytokine, Hemodialysis filter

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