全身炎症反应患者血液净化时抵抗素含量变化的研究

目的研究连续性血液净化（CBP）治疗对全身炎症反应综合征（SIRS）患者血清抵抗素含量的影响。方法将120例SIRS患者在常规对症治疗的基础上，分为常规治疗组60例；以及在常规治疗的基础上进行CBP治疗组（CBP组），CBP组患者均在常规治疗的同时行CBP治疗72h，在治疗0，24，48，72，96h时检测患者血清抵抗素含量，并进行APACHEⅡ评分。结果两组SIRS患者治疗前血清抵抗素含量均明显高于正常对照组（P〈0．01），且常规治疗组和CBP组抵抗素含量比较无统计学意义（P〉0．05），经过96h治疗，各组患者抵抗素水平均明显降低常规治疗组经过96h治疗，血清抵抗素水平降低缓慢（P〈0．05）；CBP治疗组经CBP治疗后SIRS患者血清抵抗素含量逐渐降低，治疗48h后已显著低于治疗前（P〈0．05），治疗72h后降低更为明显（P〈0．01）。SIRS患者抵抗素与APACHEⅡ评分呈正相关（r=0．58，P〈0．01）。结论CBP治疗可清除血液中炎症因子抵抗素的作用，改善患者内皮细胞功能，并为临床观察CBP的治疗效果提供了新的监测指标。

Study the effects of CBP treatment on serum resistin in patients with SIRS

Objective To study the effects of CBP treatment on serum resistin in patients with SIRS. Methods 120 patients with SIRS were randomly divided into conventional treatment group(60 cases)and CBP group(60 cases). CBP group were treated with continuous blood purification for 72 hours besides conventional treatment. Serum levels of resistin was determined with ELISA dynamically before treatment and 24,48,72and 96 hours after the treatment. The APACHE Ⅱ score was evaluated at the same time. Results The level of ser-um resistin in patients in two SIRS groups was significantly higher than control group( P <0. 01 ) ,there was no correlation between the conventional treatment group and the CBP group in the level of serum resistin ( P > 0. 05 ), after 96 hours of treatment, Patients in each group were significantly lower serum resistin. To lower serum resistin levels slow in the conventional treatment group ( P < 0. 05 ), and the gradual lowering of serum resistin levels in the CBP group ,48 hours after treatment was significantly lower than before treatment ( P < 0. 05 ), 72 hours after treatment to reduce even more pronounced( P < 0. 01 ). There was positive correlation between resis- tin and APACHE Ⅱ scores( r = 0. 68, P < 0. 01 ). Condusion CBP treatment could reduce the role of resistin which is a inflammatory factor in the blood, improve the function of endothelial ceils in patients, and treatment provides a now monitoring indicators for observation of CBP.