杂合式肾脏替代治疗高龄全身炎症反应综合征伴急性肾损伤患者的效果观察

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Abstract ObjectiveTo investigate the clinical efficacy of hybrid renal replacement therapy in the treatment of elderly patients with systemic inflammatory response syndrome accompanied with acute kidney injury.MethodsFrom May 2012 to May 2014,38 cases of systemic inflammatory response syndrome accompanied with severe acute kidney injury in elderly patients with severe pneumonia,heart disease and cerebrovascular accident were selected and divided into the HRRT group(20 cases)and the control group(18 cases)according to the different treatment methods.The HRRT group was given routine treatment combined with continuous veno venous hemofiltration plus plasma exchange(CVVHDF+PE),the control group was given routine treatment.The APACHEⅡscore,renal function,blood gas analysis,inflammatory factors and immune function index(CD4+,CD8+,CD4+/CD8+)and the half year survival rate in the two groups were compared.ResultsThe levels of CD8+,IL-10,IL-6 and TNF-α in the HRRT group after treatment was lower than that before treatment and in the control group after treatment,and the levels of CD4+,CD4+/CD8+in the HRRT group after treatment was higher than that before treatment and the control group after treatment,with significant difference(P＜0.05).The levels of pH and HCO3-in the HRRT group after treatment was higher than that before treatment and in the control group after treatment,the level of PCO2,serum Cr,serum BUN and APACHEⅡ score in the HRRTgroup after treatment was lower than that before treatment and in the control group after treatment,with significant difference(P＜0.05).The half year survival rate of the HRRT group was 85.0%,which was higher than 44.4%of the control group,with significant difference(P＜0.05).ConclusionFor systemic inflammatory response syndrome complicated with acute kidney injury due to severe pneumonia,heart disease and cerebrovascular accident syndrome,on the basis of routine treatment,early application of HRRT can effectively remove various toxins and inflammatory mediators,correct the imbalance of acid-base balance,improve the immunosuppressive status and clinical symptoms,and ultimately improve the success rate of treatment of elderly patients.

Key words： Hybrid renal replacement therapy Acute kidney injury Systemic inflammatory response syndrome

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	Articles by authors
	CUI Meng-bi
	WANG Song
	HU Shan-shan
	SU Feng-xian
	ZHA Yan

Cite this article:

CUI Meng-bi,WANG Song,HU Shan-shan, et al. Effect observation of hybrid renal replacement therapy in the treatment ofelderly patientswith systemicinflammatory responsesyndrome accompanied with acute kidney injury[J]. 中国当代医药, 2017, 24(19): 53-56.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2017/V24/I19/53

[1]	程骏章，卢宏柱，陈艳霞，等.杂合式肾脏替代治疗的研究进展[J].内科急危重症杂志，2011，17（4）：249-250.
[10]	谢先辉，万嘉豫，田茂露，等.多种模式肾脏替代治疗改善全身炎症反应综合征伴急性肾功能衰竭高龄患者的疗效分析[J].细胞与分子免疫学杂志，2016，32（9）：1251-1254.
[12]	Parmar A，Langenberg C，Wan L，et al.Epidemiology of septic acute kidney injury[J].Curr Drug Targets，2009，10（12）：1169-1178.
[2]	Xia L，Qian KJ，Zeng ZG，et al.A clinical study of early continuous high-volume-Hemofiltration in the treatment of severe acute pancreatitis[J].Zhonghua Nei Ke Za Zhi，2012，120（8）：871-874.
[3]	Keklik M，Sivgin S，Kaynar L，et al.Treatment with plama exchange may serve benefical effect in patients with severe hyperbilirubinemia：a single center experience[J].Transfus Apher Sci，2013，19（2）：323-326.
[4]	American college of chest physicians/society of critical care medicine consensus conference.Definitions of sepsis and multiple organ failure and guidelines for the useof innovative therapies in sepsis[J].Crit Care Med，1992，11（5）：864-874.
[5]	Koch T.Origin and mediators involved in sepsis and the systemic inflammatory response syndrome[J].Kidney Int，1998，2（8）：S66.
[6]	Ronco C，Bellomo R.Acute renal failure and multiple organ dysfunction in the ICU：from renal replacement therapy（RRT）to multiple organ support therapy（MOST）[J].Int J Artif Organs，2002，25（8）：733-747.
[7]	Hsu CW，Lin JL，Lin-Tan DT，et al.Early hemoperfusion may improve survival of severely Paraquat-poisoned patients[J].PLoS One，2012，22（9）：e48397.
[8]	He YC，Zhang P，Xu CP，et al.Effects of hemoperfusion on the patients with acute toxication of 2，4-dinitrophenol[J]. Zhonghua Yi Xue Za Zhi，2013，17（9）：2742-2744.
[9]	Bektas M，Idilman R，Soykan I，et al.Adjuvant therapeutic plasma exchange in liver failure：assessments of clinical and laboratory parameters[J].J Clin Gastroenterol，2008，26（6）：517-521.
[11]	Honoré PM，Jacobs R，Boer W，et al.New insights regarding rationale，therapeutic target and dose of hemofiltration and hybrid therapies in septic acute kidney injury[J].Blood Purif，2012，33（1-3）：44-51.
[13]	Joannes-Boyau O，Honoré PM，Boer W，et al.Septic acute kidney injury and inflammatory apoptosis：never a lone ranger[J].Intensive Care Med，2010，36（3）：385-388.
[14]	Silva S，de Cal M，Cruz D，et al.Oxidative stress and‘monocyte reprogramming’in septic patients with acute kidney injury requiring CRRT[J].Blood Purif，2008，26（2）：188-192.
[15]	Honoré PM，Joannes-Boyau O，Jacobs R，et al.Blood purification in sepsis：fiction or fact for the clinician[J].Reanimation，2010，19（2）：7-12.