连续性血液净化对脓毒症患者血清中Pro-ADM水平影响及预后分析

摘要

目的：探讨采用连续性血液净化对脓毒血症患者血清中Pro-ADM的影响及预后的相关性。方法：收集本院ICU收治的脓毒症患者78例，分为连续性血液净化治疗组（CBP治疗组）40例和常规治疗组38例，于治疗前及治疗后1、2、3、5、7、10 d采血，采用酶联免疫吸附法（ELISA）检测Pro-ADM、TNF-α、IL-6的水平，提取患者入组时及治疗5 d后的Pro-ADM值和SOFA评分值，差值记为d Pro-ADM和d SOFA，进行统计学分析。结果：治疗3 d后，CBP治疗组的血清Pro-ADM、TNF-α、IL-6水平较常规治疗组均显著下降（P<0.05）；治疗2 d后，与治疗前比较差异有统计学意义（P<0.05）。两组的d Pro-ADM和d SOFA比较差异均有统计学意义（P<0.05）；两组的死亡率比较差异无统计学意义（P>0.05）。结论：CBP治疗可降低脓毒血症患者血清Pro-ADM、TNF-α、IL-6的水平。Pro-ADM水平动态变化可作为经连续性血液净化治疗后效果的一个重要的指标。%Objective:To investigate effect and prognostic of continuous blood purification on Pro-ADM with sepsis.Method:78 patients with sepsis in our hospital were selected,they were divided into the continuous blood purification therapy group(the CBP group,n=40)and the conventional treatment group(n=38). Pro-ADM,TNF-α, IL-6 were detected before treatment and 1,2,3,5,7,10 days after treatment using ELISA,Pro-ADM values and SOFA scores after treatment for 5 d were noted which were subtracted before treatment,denoted d Pro-ADM and d SOFA. The above data was statistically analyzed.Result:after treatment for 3 days,the serum Pro-ADM,TNF-α,IL-6 levels in the CBP group were significantly decreased than that of the conventional group(P<0.05),after 2 days had been statistically significant difference than before treatment(P<0.05). d Pro-ADM and d SOFA were significant difference of the two groups(P<0.05);the death rate of two groups was no statistically significant difference(P>0.05).Conclusion:CBP therapy can decrease the level of serum Pro-ADM,TNF alpha and IL-6 in sepsis patients. Pro-ADM dynamic change is an important indicator of patients after continuous blood purification therapy.