重症细菌性肺炎慢性肾病患者应用连续性肾脏替代治疗的临床效果观察
The effect of continuous renal replacement therapy on the severe bacterial pneumonia patients with chronic kidney disease

孟丹.重症细菌性肺炎慢性肾病患者应用连续性肾脏替代治疗的临床效果观察[J].内科急危重症杂志,2015,21(21):

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英文关键词:severe pneumonia continuous renal replacement therapy with chronic kidney disease immunosuppressants

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作者	单位	E-mail
孟丹	广东省珠海市第二人民医院呼吸内科	xiahaifeng1977@163.com

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中文摘要:

目的：探讨长期使用免疫抑制剂合并重症肺炎的慢性肾脏疾病患者应用连续性肾脏替代治疗(CRRT)临床效果。方法：回顾性分析我院2010年4月~2013年1月收治的82例长期使用免疫抑制剂合并重症肺炎慢性肾病患者临床资料,按治疗方案分为实验组和对照组,对照组采用抗菌药物治疗,实验组患者在此基础上加用CRRT治疗,比较两组患者血气指标(SaO2、PaO2、PH)、炎症细胞(白细胞计数)、炎症因子水平(TNF-α、IL-6、IL-8、IFN-γ及CRP)及临床结局。结果：治疗前两组患者血气指标、炎症细胞及炎症因子水平比较差异均无统计学意义(P>0.05)。两组患者治疗后SaO2、PaO2、白细胞计数、及五种炎症因子与治疗前比较差异均有统计学意义(P<0.05)。两组患者PH治疗前后比较差异无统计学意义,但治疗后均已恢复正常范围。治疗后实验组患者SaO2、PaO2、白细胞计数、TNF-α、IL-6、IL-8、IFN-γ、CRP水平均优于对照组,差异有统计学意义(P<0.05)。实验组患者成功救治率为76.19%显著高于对照组的45.00% (c2=4.188,P<0.05)。结论：长期使用免疫抑制剂合并重症肺炎慢性肾病患者应用CRRT治疗可以提高炎症介质清除效果,提高治疗成功率。

英文摘要:

Objective: To investigate the effect of continuous renal replacement therapy(CRRT) on the severe bacterial pneumonia patients with chronic kidney disease. Methods: 82 patients in our hospital were collected in this study. According to the therapeutic regimen, patients were divided into the control group and the experimental group. The control group was treated by antibiotics, and the experimental group was treated by antibiotics and CRRT. SaO2, PaO2,PH,TNF-α,IL-6,IL-8,IFN-γ,CRP,leukocyte, and clinical outcome were compared. Results: Comparison of blood gas index, inflammatory cells and inflammatory factors levels of two groups showed no significant differences before treatment (P>0.05), and which were improved in different degrees after treatment. SaO2,PaO2,PH,TNF-α,IL-6,IL-8,IFN-γ,CRP and leukocyte of two group was no significant differences before treatment (P<0.05).The two groups of patients with PH had no significant difference before and after treatment. After treatment, SaO2、PaO2、PH、TNF-α、IL-6、IL-8、IFN-γ、CRP、leukocyte of the experimental group were better than the control group (P<0.05). The successful treatment rate in experimental group was 76.19%, which was higher than that of 45.00% in control group(c2=4.188,P<0.05). Conclusion CRRT could improve the removal effect of inflammatory mediators in severe pneumonia patients with chronic kidney disease.