Effects of hemoperfusion combined with continuous venovenous hemofiltration on APACHEⅡ score and serum inflammatory factor levels in patients with sepsis complicated with acute kidney injury
Objective:To investigate the efficacy of hemoperfusion(HP)combined with continuous venovenous hemofiltration(CVVH)in the treatment of sepsis complicated with Acute kidney injury(AKI),and to analyze its effects on Acute Physiology and Chronic Health status score System Ⅱ(APACHEⅡ)and serum inflammatory factor levels.Methods:A total of 92 patients with sepsis combined with AKI treated in our hospital from February 2021 to February 2023 were selected as study subjects.All patients were divided into a control group(CVVH treatment)and a study group(HP combined CVVH treatment)by the odd-even grouping method,with 46 cases in each group.The clinical efficacy and APACHE Ⅱ scores of the two groups after 7 days of treatment were compared.Before and 7 days after treatment,the levels of renal blood flow indicators were measured using the IE33 color Doppler ultrasound diagnostic instrument,renal function indicators were measured using the PUZS-600A automatic biochemical analyzer,and serum levels of interleukin-6(IL-6),vascular cell adhesion molecule-1(VCAM-1),and procalcitonin(PCT)were measured using the ELISA method.Serum levels of hypersensitive C-reactive protein(hs-CRP)were detected using immunoturbidimetry,and Toll-like receptor(TLRs)pathway-related factors,such as Toll-like receptor-2(TLR-2),Toll-like receptor-4(TLR-4),and nuclear factors-κB(NF-κB)were detected in peripheral blood monocytes by qRT-PCR method.Results:The total effective rate of the study group was higher than that of the control group(P<0.05).After treatment,the APACHEⅡ score of the study group was lower than that of the control group,and the EDV and PSV were higher than that of the control group(P<0.05).After treatment,serum levels of Scr,CysC,hs-CRP,IL-6,VCAM-1,and PCT in the study group were lower than those in the control group,and renal aminase levels were higher than those in the control group(P<0.05).After treatment,the mRNA levels of TLR-2,TLR-4,and NF-κB in the peripheral blood of the study group were lower than those of the control group(P<0.05).Conclusion:HP combined with CVVH is effective in the treatment of sepsis complicated with AKI,which can effectively control the progression of the disease,improve the renal blood flow and kidney function,and reduce the inflammatory injury of the body,which may be related to inhibiting the activation of TLRs pathway.
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