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连续性血液净化对脓毒症急性肾损伤患者单核细胞CD14+HLA-DR表达的影响

Chinese Journal of Integrated Traditional and Western Nephrology(2020)

Cited 13|Views45
Abstract
目的:探讨脓毒症合并急性肾损伤(AKI)患者在经过CVVH治疗后促炎介质和单核细胞CD14+HLA-DR的表达与肾功能改善的关系.方法:对我科2016年06月~2018年06月共35例脓毒症合并AKI患者住院患者进行观察,分为肾功能改善组和未改善组,两组患者分别在CVVH治疗前和第5天、第15天抽取血,送检项目包括血肌酐、TNF-α、IL-6、外周血单核细胞CD14+HLA-DR的表达.记录患者肾功能改善及ICU死亡情况.结果:(1)CVVH治疗5 d后,肾功能改善组TNF-α水平在治疗后下降,与治疗前比较差异有统计学意义(P<0.05).与未改善组TNF-α组间比较差异有统计学意义.(2)两组患者CVVH治疗前单核细胞CD14+HLA-DR表达差异无统计学意义,治疗5 d后肾功能改善组单核细胞CD14+HLA-DR比治疗前表达增强,差异有统计学意义(P<0.05).而肾功能未改善组未显示出差异有统计学意义.结论:脓毒症AKI经过CVVH治疗后血浆TNF-α、单核细胞CD14+HLA-DR可能参与了细胞免疫调节的作用,并可能与脓毒症AKI肾功能恢复有关.
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要点】:研究脓毒症合并急性肾损伤(AKI)患者在连续静脉-静脉血液滤过(CVVH)治疗后,血浆TNF-α及单核细胞CD14+HLA-DR表达变化与肾功能恢复的关系,发现这些指标与细胞免疫调节和肾功能恢复有潜在的关联。

方法】:通过观察35例脓毒症合并AKI患者,分为肾功能改善组和未改善组,收集CVVH治疗前及治疗第5天、第15天的血液样本,检测血肌酐、TNF-α、IL-6及外周血单核细胞CD14+HLA-DR的表达。

实验】:使用的数据集为2016年06月至2018年06月间的住院患者数据,实验结果显示肾功能改善组在CVVH治疗5天后TNF-α水平显著下降,单核细胞CD14+HLA-DR表达增强,而肾功能未改善组这些变化不显著。