中国血液净化

›› 2006, Vol. 5 ›› Issue (8): 418-421.

• 论著 • 上一篇    下一篇

血液灌流对急性肾衰竭患者微炎症状态的影响　　　

齐辰利 李荣山 李彩霞 邵 珊 程丽娟 高仁义 张 瑜 李元红 刘 静 成秀芬   

  1. 030001 太原，山西医科大学第二医院
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2006-08-12 发布日期:2006-08-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2006-08-12 Published:2006-08-12

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摘要： 目的 观察急性肾衰竭（ARF）患者体内炎症因子的表达情况及血液灌流对其的清除效果。方法　选择山西医科大学第二医院肾内科确诊的肾性单纯型ARF患者76例，随机分为两组：血液灌流联合血液透析组（HP+HD组）和单纯血液透析组（HD组），每组各38例，分别于治疗前、后采血；健康人25例作为对照组；ELISA方法检测血中C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)水平。结果　透析及灌流治疗前两组患者血CRP、IL-6、TNF-α水平均高于正常对照组（P＜0.001），两组之间各因子水平差异无显著性（P＞0.05）；透析及灌流治疗前3组各因子相互之间呈显著正相关 （P＜0.001）；透析及灌流治疗后各因子水平较治疗前降低，其中(HP+HD)组差异有统计学意义（P＜0.001），HD组差异无统计学意义（P＞0.05）。结论 ARF患者可能存在类似慢性肾衰竭（CRF）的微炎症状态，血液灌流是其有效的治疗手段。

关键词: 血液灌流, 急性肾衰竭, 微炎症状态

Abstract: Objective To observe levels of serum inflammatory factors and effect of hemoperfusion (HP) on acute renal failure(ARF) patients. Methods Seventy-six patients with simple ARF(without acute or chronic infection, malignancy,multiple organ failure,glucocorticoid and immunosuppressant treatment,history of blood transfusion)were randomly divided into hemoperfusion combined with hemodialysis (HD) group (HP+HD group, n=38) normal control group consisted of 25 healthy people. The serum CRP, IL-6 and TNFα levels of all patients and controls were detected by ELISA before and after the treatments. Results The serum CRP, IL-6 and TNFα levels in both treatment groups were significantly higher than those in control group(P＜0.001), and there were no significant difference between two treated groups before treatment(P＞0.05). The levels of CRP, IL-6 and TNFαhad significant positive correlation in all groups(P＜0.001); The serum CRP,IL-6 and TNFα levels decreased after treatment, and there was significant difference in HP+HD group (P＜0.001), but not in HD group (P＞0.05). Conclusion There are high levels of microinflammatory factors such as CRP, IL-6 and TNFαin ARF patients, which may be the evidence of microinflammatory state in ARF patients as CRF patients. The study also suggests that HP is an effective method to remove increased inflammatory factors in ARF patients.

Key words: Acute renal failure, Microinflammatory state

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