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目的:观察高容量血液滤过(HVHF)对多器官功能障碍综合征(MODS)患者炎症介质的清除作用,探讨HVHF对MODS患者的治疗效果。方法:19例MODS患者随机分为两组,HVHF治疗组10例,连续性静脉-静脉血液滤过(CVVH)治疗组9例;用酶联免疫吸附法(ELISA)测定HVHF和CVVH治疗前和治疗后患者血清中肿瘤坏死因子-α(TNFα)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)水平,并观察两组患者的死亡率和血浆尿素氮(BUN)、肌酐(Scr)值的变化。结果:HVHF和CVVH治疗后,患者血浆中BUN、Scr均降低(P<0.05),两组患者治疗后与治疗前相比血清TNFα、IL-6、IL-8水平均有下降(P<0.05);与CVVH治疗组相比,HVHF治疗组患者血清中TNFα、IL-6、IL-8下降更为明显(P<0.05)。结论:HVHF治疗能明显增加MODS患者血清中TNFα、IL-6、IL-8的清除能力,改善MODS患者的预后。
Objective: To observe the scavenging effect of high-volume hemofiltration (HVHF) on inflammatory mediators in patients with multiple organ dysfunction syndrome (MODS) and to explore the therapeutic effect of HVHF on MODS patients. Methods Nineteen MODS patients were randomly divided into two groups: HVHF treatment group (n = 10) and continuous venovenous hemofiltration (CVVH) treatment group (n = 9). Enzyme linked immunosorbent assay (ELISA) After treatment, the level of TNF-α, IL-6 and IL-8 in the serum of patients were observed. The mortality and plasma urea nitrogen BUN), creatinine (Scr) value changes. Results: After the treatment of HVHF and CVVH, the levels of BUN and Scr in plasma decreased (P <0.05), and the levels of TNFα, IL-6 and IL-8 decreased after treatment in both groups ). Compared with CVVH treatment group, the levels of TNFα, IL-6 and IL-8 in HVHF treatment group decreased more significantly (P <0.05). Conclusion: HVHF treatment can significantly increase the clearance of TNFα, IL-6 and IL-8 in MODS patients and improve the prognosis of MODS patients.