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目的:观察血液灌流技术对急性肾衰竭(ARF)患者外周血促炎症因子白细胞介素1β(IL-1β)、血清淀粉样蛋白A(SAA)及抗炎症因子白细胞介素10(IL-10)表达的影响。方法:选择山西医科大学第二临床医院肾内科确诊的ARF患者80例,随机分为血液灌流联合血液透析组(HP+HD组)和单纯血液透析组(HD组)两组,每组40例。分别于治疗前、治疗后采血;另选20例健康体检者为对正常对照组;ELISA方法检测各组血清中IL-1β、SAA、IL-10水平。结果:①灌流及透析治疗前两组患者血清IL-1β、SAA水平均高于正常对照组(P<0.01),两组之间IL-1β、SAA水平差异无统计学意义(P>0.05);IL-10水平高于正常对照组,但差异无统计学意义(P>0.05);②灌流及透析治疗后两组患者血清IL-1β、SAA水平较治疗前降低,其中HP+HD组差异有统计学意义(P<0.01),HD组差异无统计学意义(P>0.05);HP+HD组治疗后IL-10水平较治疗前有所降低,但差异无统计学意义(P>0.05),HD组治疗前后IL-10水平无明显变化。结论:急性肾衰竭患者外周血促炎症因子IL-1β、SAA及抗炎症因子IL-10均较正常对照组升高,存在炎症反应;血液灌流能清除急性肾衰竭患者外周血中促炎症因子IL-1β、SAA,而对抗炎症因子IL-10无明显作用。
Objective: To observe the effects of hemoperfusion technique on interleukin-1β (IL-1β), serum amyloid A (SAA) and anti-inflammatory factor interleukin 10 (IL-10) in peripheral blood of patients with acute renal failure The impact of expression. Methods: Eighty ARF patients diagnosed by Department of Nephrology, The Second Clinical Hospital of Shanxi Medical University were randomly divided into two groups: hemoperfusion group (HP + HD group) and hemodialysis group (HD group) . Blood samples were collected before treatment and after treatment. Another 20 healthy subjects were selected as normal control group. Serum levels of IL-1β, SAA and IL-10 were detected by ELISA. Results: ① The levels of serum IL-1β and SAA in the two groups before and after perfusion and dialysis were higher than those in the normal control group (P <0.01). There was no significant difference in the levels of IL-1β and SAA between the two groups (P> 0.05) ; IL-10 levels were higher than the normal control group, but the difference was not statistically significant (P> 0.05); ②Serum levels of IL-1β and SAA in both groups decreased after perfusion and dialysis treatment, (P <0.01). There was no significant difference in HD group between the two groups (P> 0.05). The level of IL-10 in HP + HD group was lower than that before treatment, but the difference was not statistically significant ), There was no significant change of IL-10 level in HD group before and after treatment. Conclusion: The levels of proinflammatory cytokines IL-1β, SAA and anti-inflammatory factor IL-10 in peripheral blood of patients with acute renal failure are higher than those in normal control group, and there is an inflammatory reaction. Hemoperfusion can clear the levels of proinflammatory cytokines IL -1β, SAA, and anti-inflammatory factor IL-10 no significant effect.