连续性血浆滤过吸附对重症急性胰腺炎细胞因子的调节作用

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Abstract Objective To investigate the effect of continuous plasma filtration adsorption (CPFA) on severe acute pancreatitis and its effects on tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and interleukin-10 (IL-10). Methods A total of 40 patients with severe acute pancreatitis were selected from October 2014 to June 2018 in the Department of Severe Medicine of Dalian Central Hospital. They were divided into control group (n = 20) and treatment group (n = 20) according to the treatment method. The control group was treated with continuous venovenous hemofiltration (CVVH) for 72 hours on the basis of routine treatment, while the treatment group was treated with CPFA on the basis of the control group. The levels of TNF-α, IL-6 and IL-10 in blood were measured before and after treatment for 3 and 7 days. The vital signs, intra-abdominal pressure, acute physiology and chronic health (APACHEⅡ) scores were compared between the two groups before and after treatment, and the organ function was evaluated, adverse reactions and prognosis were observed. Results There was no significant difference in the clinical indexes between the two groups before treatment (P > 0.05). After 3 days of treatment, the heart rate, oxygenation index, intra-abdominal pressure and APACHE Ⅱ scores of the two groups were lower than those before treatment, and the average arterial pressure and white blood cell count were higher than those before treatment (P < 0.05); the heart rate and intra-abdominal pressure of the treatment group were lower than those of the control group, and the average arterial pressure was higher than that of the control group (P < 0.05). After 7 days of treatment, the heart rate, white blood cell count, intra-abdominal pressure and APACHE Ⅱ scores of the two groups were lower than those before treatment, and the average arterial pressure and oxygenation index were higher than those before treatment (P < 0.05); the heart rate, intra-abdominal pressure and APACHE Ⅱ scores of the treatment group were lower than those of the control group, and the average arterial pressure was higher than that of the control group, with significant differences (P < 0.05). There was no significant difference in the levels of TNF-α, IL-6 and IL-10 between the two groups before treatment (P > 0.05). After 3 days of treatment, the levels of pro-inflammatory cytokines TNF-α, IL-6 in the two groups decreased, the levels of TNF-α and IL-6 in the treatment group were lower than those in the control group (P < 0.05), and the levels of anti-inflammatory cytokines IL-10 in both groups were increased (P < 0.05), and the level of IL-10 in the treatment group was higher than that in the control group (P < 0.05). After 7 days of treatment, the levels of pro-inflammatory cytokines in the two groups decreased further, and the treatment group was lower than the control group, the difference was statistically significant (P < 0.05); while the anti-inflammatory cytokine levels were further increased, and the treatment group was higher than the control group, the difference was statistically significant (P < 0.05). The average hospitalization days and the time needed to continue blood purification treatment in the treatment group were significantly shorter than those in the control group (P < 0.05), but there was no significant difference in mortality between the two groups (P > 0.05). Conclusion CPFA can better regulate the levels of cytokines in the blood, thereby improving clinical symptoms, shortening treatment time and treating severe acute pancreatitis.

Key words： Severe acute pancreatitis Continuous plasma filtration adsorption Continuous veno-venous hemofiltration Cytokine

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	ZHOU Hengjie LIU Sibo SHU Jiaojie

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ZHOU Hengjie LIU Sibo SHU Jiaojie. Effect of continuous plasma filtration adsorption in the treatment of severe acute pancreatitis[J]. 中国医药导报, 2019, 16(4): 92-95,99.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2019/V16/I4/92

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