连续性肾脏替代治疗对多器官功能障碍综合征患者肿瘤坏死因子和白细胞介素6水平的影响

摘要

目的 研究连续性肾脏替代治疗(CRRT)对多器官功能障碍综合征(MODS)患者肿瘤坏死因子(TNF-α)和白细胞介素6(IL-6)水平的影响,探讨其对MODS的治疗作用和机制.方法 将40例MODS患者按治疗方法分为CRRT组19例和对照组21例.CRRT组在常规综合保守治疗基础上使用CRRT,连续治疗3 d;对照组仅常规综合保守治疗.比较2组的临床疗效.同时比较2组外周血TNF-α和IL-6在治疗前后各时间点的含量.结果 CRRT组治愈16例,好转2例,治愈率为84.2%;对照组治愈12例,好转6例,治愈率57.1%.2组治愈率比较,差异有统计学意义(P＜0.05).CRRT组19例患者治疗后肾功能及总胆红素明显好转.CRRT组治疗后TNF-α和IL-6较治疗前呈显著降低,差异有统计学意义.2组TNF-α分别为(115.0±27.8)ng/L与(178.6±35.6)ng/L;IL-6分别为(86.5±23.3)ng/L与(122.7±28.6)ng/L,组间差异有统计学意义.结论 CRRT治疗能有效降低TNF-α和IL-6含量,治疗MODS疗效确切.%Objective To study the impact of continuous renal replacement therapy(CRRT) on tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) in multiple organ dysfunction syndrome(MODS).Methods Forty patients with MODS were divided randomly into the CRRT group (therapeutic group,19 patients) and non-CRRT group(contrast greup,21 patients).Both groups were treated with conventional therapies.Organ function recovery time,tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) levels were also detected on the first day and seventh day of admission.Results The recovery time of organ function was significantly decreased compared with that of the contrast group.The TNF-α and IL-6 detected at the end after CRRT were decreased significantly compared with those in the contrast group[TNF-α:(115.0±27.8) ng/L vs (78.6±35.6) ng/L;IL-6 (86.5±23.3) ng/L vs (122.7±28.6)ng/L].Conclusions The result shows that the TNF-α and IL-6 is overproduced during the development of MODS and can be removed effectively by means of CRRT.CRRT has a good therapeutic effect on MODS.