| 选择性粒细胞吸附装置治疗重症急性肾损伤的研究 |
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| 引用本文： | 周莹,谢琼虹,刘骏峰,许钟烨,匡鼎伟,游怀舟,赖凌云,顾勇,郝传明,林善锬,丁峰,H.David Humes.选择性粒细胞吸附装置治疗重症急性肾损伤的研究[J].中国血液净化,2011,10(11):602-605. |
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| 作者姓名： | 周莹 谢琼虹 刘骏峰 许钟烨 匡鼎伟 游怀舟 赖凌云 顾勇 郝传明 林善锬 丁峰 H.David Humes |
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| 作者单位： | 1. 复旦大学附属华山医院肾脏科,上海,200040
2. Department of Medicine,University of Michigan Medical School,Ann Arbor,Michigan,USA |
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| 基金项目： | 国家自然科学基金，上海市科学技术委员会项目，上海市浦江人才项目，国家自然科学基金，复旦大学附属华山医院科研启动基金 |
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| 摘 要： | 目的初步观察选择性粒细胞吸附装置(selective cytopheretic device,SCD)联合连续性静静脉血液滤过(continuous veno-venous hemofiItration,CVVH)治疗重症急性肾损伤(acute kidney injury,AKI)患者的疗效,并观察不良事件的发生情况.方法本研究重症AKI的定义为临床诊断为缺血性或肾毒性急性肾小管坏死,同时至少有1个肾外器官衰竭或存在脓毒血症.入选者除给予标准的重症监护治疗外,还同时接受SCD联合CVVH治疗.历史对照组为改善急性肾脏疾病照护计划(the program to improve care in acute renal disease,PICARD)研究中年龄和序贯器官衰竭评分(sequential organ failure assessment,SOFA)评分匹配的患者.主要终点事件为院内全因死亡.其他观察指标包括尿量变化及不良反应情况.使用Cox回归模型校正混杂因素,分析SCD联合CVVH治疗模式的疗效是否优于常规CVVH治疗.结果共入选9例重症AKI患者.SCD联合CVVH治疗组院内全因死亡率为22.2%,显著低于历史对照组(77.8%)(X2=5.247,P=0.027).在校正年龄、SOFA评分、平均尿量变化等混杂因素后,Cox回归模型显示,SCD联合CVVH的疗效优于常规CVVH治疗(T=-2.596,P=0.0222).治疗7d后,SCD治疗组平均尿量从基线值约500ml/d升高至2000ml/d以上.研究过程中,患者仅有数例轻度不良反应,无严重不良事件发生.结论 SCD可通过灭活激活的白细胞而调控机体免疫反应,最终降低重症AKI患者的死亡率.SCD安全性良好.
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| 关 键 词： | 选择性粒细胞吸附装置 急性肾损伤 炎症 白细胞激活 连续性血液滤过 |
The effects of the selective cytopheretic device on outcome of severe acute kidney injury: a pilot study |
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| ZHOU Ting,XIE Qiong-hong,LIU Jun-feng,XU Zhong-ye,KUANG Ding-wei,YOU Huai-zhou,LAI Ling-yun,GU Yong,HAO Chuan-ming,LIN Shan-yan,DING Feng,H.David Humes.The effects of the selective cytopheretic device on outcome of severe acute kidney injury: a pilot study[J].Chinese Journal of Blood Purification,2011,10(11):602-605. |
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| Authors: | ZHOU Ting XIE Qiong-hong LIU Jun-feng XU Zhong-ye KUANG Ding-wei YOU Huai-zhou LAI Ling-yun GU Yong HAO Chuan-ming LIN Shan-yan DING Feng HDavid Humes |
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| Institution: | ZHOU Ying1,XIE Qiong-hong1,LIU Jun-feng1,XU Zhong-ye1,KUANG Ding-wei1,YOU Huai-zhou1,LAI Ling-yun1,GU Yong1,HAO Chuan-ming1,LIN Shan-yan1,DING Feng1,H. David Humes2 1Division of Nephrology,Huashan Hospital,Fudan University,Shanghai,200040 China,2Department of Medicine,University of Michigan Medical School,Ann Arbor,Michigan,USA |
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| Abstract: | Objectives To evaluate the effect of the selective cytopheretic device (SCD) on outcome of severe acute kidney injury (AKI) requiring renal replacement therapy, and to observe the occurrence of adverse events from application of the device. Methods In this study, acute kidney injury was defined as ischemic or nephrotoxic acute tubular necrosis by clinic diagnosis, with at least one nonrenal organ failure or presence of sepsis at the same time. All subjects received standard intensive care treatment with con... |
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| Keywords: | Selective cytopheretic device Acute kidney injury Inflammation Leukocyte activation Continuous hemofiltration |
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