连续性血液净化治疗多器官功能衰竭与Th1/Th2失衡的临床研究

彭侃夫; 吴雄飞; 赵洪雯; 王军霞; 吴亿; 赵笑兰

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中国血液净化 ›› 2005, Vol. 4 ›› Issue (2) : 83-85.

论著

连续性血液净化治疗多器官功能衰竭与Th1/Th2失衡的临床研究

彭侃夫吴雄飞　赵洪雯　王军霞　吴亿　赵笑兰

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摘要

目的研究连续性血液净化治疗( CBP)对多器官功能衰竭患者Th1/Th2失衡的影响。方法 28例多器官功能障碍综合征（MODS）患者行CBP治疗。采用中心静脉留置单针双腔导管建立血管通路，采用Prisma连续性血液净化系统、以及配套的M60管路和血滤器AN69(PAN膜，2.0cm2)进行前稀释连续性静脉-静脉血液透析滤过（CVVHDF）。治疗前及治疗后24h,48h,72h采血检测Th1/Th2。结果 22例患者肾功能均恢复正常。在CBP治疗开始后24h血Th1/Th2比值逐渐上升，48h下降有显著差异，72h接近正常。24h与开始前比较，72h与24h比较有统计学差异（P<0.01）。结论 CBP治疗可能可平衡Th1/Th2。

Abstract

Objective To study the effects of continuous blood purification on patients with MODS and Th1/Th2 inbalance. Methods Twenty-eight patients with multiple organ dysfunction syndrome (MODS) were treated with continuous blood purification(CBP), the vascular access established with two-lumen indwelling catheter in vena profundae or internal arteriovenous fistula, Prisma（Hospal）system for continuous venovenous hemodiafiltration(CVVHDF), the Gambro AN69 dialyzers with polyacrylonitrile(PAN) membrane were used. The Th1/Th2 cytokines in plasma were checked before and 24h、48h、72h after CBP. Results The renal function of 22 patients recovered. The plasma Th1/Th2 cytokines increased progressively after CBP 24h,nearly normal at 72h and after 48h there was significant difference compared with that before CBP(P<0.01). Conclusion blood purification(CBP) may correct the inbalance of Th1/Th2