CRRT对输尿管结石梗阻并发尿脓毒症患者外周血免疫状态的影响
Effects of CRRT on peripheral immune status in patients with ureteral calculi obstruction com-plicated with urosepsis
张立颖 1段刘剑 1张林 1曹建伟 1钱苏波 1黄云腾1
作者信息
- 1. 上海交通大学医学院附属新华医院泌尿外科,上海 200092
- 折叠
摘要
目的 探讨持续性肾脏替代疗法(CRRT)对输尿管结石梗阻并发尿脓毒症患者的治疗效果及外周血免疫状态的影响.方法 回顾性分析2021年9月至2022年3月本院收治的24例输尿管结石梗阻并发尿脓毒症且治疗痊愈的患者的临床资料,其中6例接受CRRT治疗(CRRT组),18例仅接受标准治疗(对照组),比较两组患者的疗效及外周血炎症指标等的变化差异.结果 尿脓毒症患者接受连续性肾脏替代治疗(CRRT)的治疗效果显著.CRRT组中的患者表现出较短的体温恢复时间[(4.5±1.8)d vs.(5.4±1.8)d],感染控制时间[(6.0± 1.3)dvs.(7.3±2.2)d]以及肌酐恢复时间[(4.6±3.6)dvs.(5.7±2.4)d].CRRT 组患者治疗后的白细胞计数、C反应蛋白和炎症因子(IL-10、IL-6、IL-、TNF-α)水平均较治疗前显著下降,且下降速度快于对照组.结论 CRRT能快速、有效地清除输尿管结石梗阻并发尿脓毒症患者体内的炎症因子,调节外周血免疫状态,从而缩短患者病程,改善患者预后.
Abstract
Objective To investigate the therapeutic effects of continuous renal replacement therapy(CRRT)in patients with ureteral calculi obstruction complicated with urosepsis and the influ-ences on the peripheral immune status.Methods A retrospective analysis was performed on 24 pa-tients with ureteral calculi obstruction complicated with urosepsis who got fully recovery in our hospital from September 2021 to March 2022,including 6 patients who received CRRT treatment(CRRT group)and the remaining 18 patients received only standard treatment(control group).The therapeu-tic effects and the dynamic variation patterns of some serum pro-inflammatory cytokines and anti-in-flammatory cytokines were compared between two groups.Results The treatment outcomes of patients with pyelonephritis undergoing CRRT are significant.Patients in the CRRT group exhibited shorter body temperature recovery time[(4.5±1.8)d vs.(5.4±1.8)d],infection control time[(6.0± 1.3)d vs.(7.3±2.2)d],and creatinine recovery time[(4.6±3.6)d vs.(5.7±2.4)d]compared to the control group.Furthermore,patients in the CRRT group experienced a significant decrease in white blood cell count,Creactive protein,and inflammatory cytokines(IL-10,IL-6,IL-8,TNF-α)levels post-treatment,with a significantly faster decline compared with the control group.Conclusions CRRT can rapidly and effectively remove inflammatory factors in patients with ureteral calculi ob-struction complicated with urosepsis,regulate peripheral immune status,thereby shortening the course of disease and improving the prognosis of patients.
关键词
输尿管结石/尿源性脓毒症/连续性肾脏替代治疗/炎症因子Key words
Ureteral Calculi/Urinary Sepsis/Continuous Renal Replacement Therapy/Inflam-matory Factor引用本文复制引用
出版年
2024
NETL
NSTL
维普
万方数据