连续性血液净化对严重创伤后并发ARDS患者细胞因子及内毒素的影响

【目的】探讨连续性血液净化(CBP)对严重创伤后并发急性呼吸窘迫综合征(ARDS)患者细胞因子及内毒素(endotoxin,ETX)的影响。【方法】选择25例严重创伤后并发ARDS患者,分成两组,A组:15例,用常规方法治疗;B组:10例,除常规方法治疗外,加用CBP治疗,12h/d;另设10例年轻健康献血人员为对照组(C组)。【结果】B组患者在CBP治疗后血浆ETX和细胞因子有不同程度下降,在CBP后d1,d3,d5,d7的血浆ETX和细胞因子较A组同期水平低。【结论】早期使用CBP治疗能改善严重创伤并发患者的ETX血症,阻断其细胞因子反应。

Effect of Continuous Blood Purification on Endotoxin and Cytokines in Patients with ARDS after Severe Injury

Objective] To explore the effect of continuous blood purification(CBP)on endotoxin(ETX)and cytokines in patients with cute respiratory distress syndrome(ARDS)after severe injury,and to provide experimental bases for treating severe injure patients as an adjuvant method.Methods] Twenty five severe injury cases with ARDS after severe injury were divided into Group A(n=15,treated with traditional methods),Group B(n=10,added to CBP for 12 hours /day based on traditional methods),and Group C(as controls,n=10,young healthy blood donors).Endotoxin and cytokines in plasma in each group at the accordant time were measured.Results] Endotoxin and cytokines in plasma in Group B decreased in different degrees after CBP.The levels of endotoxin and cytokines at the 1st,3rd and 5th day after CBP in Group B were lower than those in Group A at according time.Conclusion] CBP at the early stage can obviously improve endotoxemia of patients with ARDS after severe injury and block the reaction of cytokines.