中国血液净化

中国血液净化 ›› 2018, Vol. 17 ›› Issue (02): 78-81.doi: 10.3969/j.issn.1671-4091.2018.02.002

• 临床研究 • 上一篇    下一篇

连续性肾脏替代治疗改善脓毒症患者早期肝功能障碍的临床探讨

蔡婷婷1,梁永明1,薛秋平1,陈勇1   

  1. 1. 广东阳江市人民医院重症医学科一区
  • 收稿日期:2017-07-18 修回日期:2017-12-17 出版日期:2018-02-12 发布日期:2018-02-12
  • 通讯作者: 陈勇 cheny66@163.com E-mail:cheny66@163.com

The effect of continuous renal replacement therapy on patients with early hepatic dysfunction induced by sepsis

  • Received:2017-07-18 Revised:2017-12-17 Online:2018-02-12 Published:2018-02-12

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摘要： 目的探讨连续性肾脏替代治疗(continuous renal replacement therapy，CRRT)对脓毒症早期肝功能障碍患者的治疗效果。方法收集阳江市第一人民医院2013 年1 月～2016 年12 月入住ICU 的严重肺部感染合并脓毒症肝功能障碍患者287 例，所有患者随机分为CRRT 治疗组与对照组(常规药物治疗组),其中CRRT 治疗组156 例，对照组131 例。所有患者在检测出肝功能异常后的第1d、3d、7d 清晨分别抽血检测丙氨酸氨基转移酶(alanine aminotransferase，ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase，AST)、总胆红素(serum total bilirubin，STB)、白蛋白(albumin,Alb)、凝血酶原时间(prothrombin time，PT)等肝功能指标用于统计分析。结果2 组患者治疗3 天后，与对照组比较AST(F=8.705，P=0.014)、STB(F=9.016，P=0.009)差异具有统计学意义，白蛋白、PT、ALT 差异无统计学
意义(P＞0.05)。经过7 天治疗后，与对照组比较ALT(F=8.413，P=0.016)、AST(F=7.812，P=0.023)、STB(F=9.413，P=0.005)差异具有统计学意义；白蛋白、PT 差异无统计学意义(P＞0.05)。结论CRRT 能显著改善脓毒症早期肝功能障碍患者的肝功能状态。

关键词: 连续性肾脏替代治疗, 脓毒症, 肝功能障碍, 丙氨酸氨基转移酶, 天门冬氨酸氨基转移酶

Abstract: Objective To investigate the clinical effects of continuous renal replacement therapy (CRRT) for the treatment of patients with early hepatic dysfunction induced by sepsis. Methods A total of 287 cases with liver dysfunction after severe pulmonary infection and sepsis and treated in the ICU of First People's Hospital of Yangjiang city from Jan. 2013 to Dec. 2016 were recruited. The patients were randomly divided into CRRT group (n=156) and control group (routine treatment group, n=131). Blood samples were collected at the 1st, 3rd and 7th day in the early morning after the presence of hepatic dysfunction for the measurement of alanine aminotransfease (ALT), aspartate aminotransferase (AST), serum total bilirubin (STB), albumin (ALB) and prothrombin time (PT). Laboratory parameters were used for statistical analyses. Results After the treatment for 3 days, changes of AST (F=8.705, P=0.014) and STB (F=9.016, P=0.009) were statistically significant (P＜0.05) in CRRT group as compared with those in control group, but ALB, ALT and PT had no statistical differences (P＞0.05). After the treatment for 7 days, changes of ALT (F=8.413, P=0.016), AST (F=7.812, P=0.023) and STB (F=9.413, P=0.005) were statistically significant (P＜0.05) as compared with those in control group, but ALB and PT had no statistical differences (P＞0.05). Conclusion CRRT can improve the patients with early liver dysfunction induced by sepsis.

Key words: CRRT, Sepsis, Hepatic Dysfunction, ALT, AST