中国血液净化

›› 2005, Vol. 4 ›› Issue (2): 73-76.

• 论著 • 上一篇    下一篇

连续性血液净化阻断SARS发病早期病情进展的初步研究

陈 煜 段钟平 李德新 朱彦涛 李 颖 郭会敏 张爱东 赵 军   

  1. 100054 北京，首都医科大学附属北京佑安医院人工肝及血液净化中心
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2005-02-12 发布日期:2005-02-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2005-02-12 Published:2005-02-12

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摘要：

目的 快速进展的重症患者是SARS死亡的主要原因。本研究旨在借助连续性血液净化技术， 探讨阻断SARS病情进展及重症化、降低病死率的新的治疗方法。方法 3例急性期SARS患者进行了连续性静脉-静脉血液滤过（CVVHF）治疗。观察治疗前后心率、呼吸、平均动脉压、血气分析及胸部病灶影像学变化。留取血清和滤液标本进行细胞因子测定。结果 患者治疗后临床症状和心率、呼吸、平均动脉压等指标改善，胸片及CT示肺部炎症浸润迅速吸收，病程明显缩短。随血液滤过的进行，患者血清IL-1β、IL-2、IL-6、IL-10、TNF-a等细胞因子水平进行性下降。结论 连续性静脉-静脉血液滤过治疗可有效控制SARS患者早期存在的系统性炎性反应综合症（SIRS）状态，阻断病情进展，可能是减少SARS重症化、降低病死率的有效手段和方法。

关键词: 连续性血液净化, 严重急性呼吸综合征, 细胞因子, 治疗

Abstract:

Objective To investigate the clinical effect of continuous blood purification on blocking the development of severe acute respiratory syndrome, and provide information for further mechanism and clinical treatment study. Methods Continuous veno-venous hemofiltration(CVVHF) were performed in 3 SARS patients in acute phase. Some important clinical parameters such as cardiac rate, respiration, mean arterial pressure, blood gas analysis were recorded before and after the treatment. Serum cytokines were examined at different time of the operating programme. Results The symptoms, cardiac rate, respiration, mean arterial pressure were ameliorated after the treatment. The lung inflammatory signs were obviously improved, and the duration of hospitalization were shortened. The levels of IL-1β,IL-2,IL-6,IL-10 and TNF-a decreased gradually during the CVVHF treatment. Conclusion Continuous blood purification can effectively relieve the state of systemic inflammatory response syndrome, and block the development of early stage of SARS. It may be a more effective and prospecting method for advanced SARS.

Key words: Severe acute respiratory syndrome, Cytokine, Treatment

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