早期短时间断血液滤过对急性重症胰腺炎患者炎性细胞因子的影响

目的探讨短时间断血液滤过（ISVVH）对重症急性胰腺炎（SAP）治疗患者炎性细胞因子的影响。方法16例SAP患者行ISVVH治疗（ISVVH组），同期16例SAP患者未行ISVVH治疗（对照组）。测定及比较两组患者在入院时、治疗1、2、3、7d抗炎细胞因子（TNF-α、IL-1β、IL-6）和促炎细胞因子（IL-1ra、IL-4、IL-10）值。结果ISVVH组14例治愈出院，2例死亡；对照组11例治愈出院，5例死亡。两组抗、促炎细胞因子在治疗1、2、3、7d比较差异均有显著性（P〈0．05）（IL-1ra值在治疗1d后比较除外）。结论SAP患者采用ISVVH治疗，能有效改善体内炎性细胞因子的平衡，提高早期救治成功率。

Clinical research of intermittent short veno-venuous hemofiltration(ISVVH) on pro-inflammatory cytokine and anti-inflammatory cytokine of patients with severe acute pancreatitis

Objective To discuss the value of intermittent short veno-venuous hemofiltration（ISVVH） on pro-inflammatory cytokine and anti-inflammatory cytokine of severe acute pancreatitis （SAP） patients. Methods 16 SAP patients underwent ISVVH from 2005 to 2007. The other 16 patients who did not receive hemofiltration were chosen as control group （N group）, and the plasma level of TNF-α, IL-1β, IL-6 and IL-1ra, IL-4, IL-10 were observed respectively everyday. Results Among 16 patients, 14 were cured and 2 died, the mortality being 12.5%. After ISVVH, the ha- emodynamics were stabile during ISVVH. No obvious side effect related to ISVVH was found. The plasma concentration of the 3 pro-inflammatory cytokines after ISVVH was decreased significantly （P〈0.05）, compared with that observed in pre-hemofiltration and in the N group at each observation point. The plasma concentration of the two anti-inflammatory cytokines was increased significantly（P〈0.05）, compared with those observed pre-hemofiltration and in the N group at each observation point except the plasma concentration of IL-1 ra. Conclusions ISVVH is an important part during the treatment of SAP, and it can obviously change patients＇ pro-inflammatory eytokine and anti-inflammatory cytokine level and establish a new balance.