Effect of HP+CVVH on vascular endothelial function and renal tubular function in patients with severe acute pancreatitis and acute renal injury
Objective To explore the effect of hemoperfusion(HP)+continuous veno-venous hemofiltration(CVVH)on vascular endothelial function and renal tubular function in patients with severe acute pancreatitis and acute renal injury.Methods 118 patients with severe acute pancreatitis and acute renal injury were selected and divided into an observation group(68 cases)and a control group(50 cases)according to different treatment methods.The control group was treated with HP,and the observation group was treated with HP+CVVH.Both groups were compared in terms of treatment,vascular endothelial function indicators[endothelin-1(ET-1),vascular endothelial growth factor(VEGF),and von Willebrand factor antigen(vWF:Ag)],renal tubular function indicators[urinary retinol binding protein(RBP),urinary N-Acetyl-β-d-glucosaminidase(UNAG)],and serum inflammatory factors[C-reactive protein(CRP),interleukin-2(IL-2),tumor necrosis factor-α(TNF-α)].Results The fatality rate of the observation group was 1.47%(1/68),which was lower than 8.00%(4/50)of the control group,but the difference was not statistically significant(P＞0.05).In the observation group,the disappearance time of abdominal pain was(2.67±0.51)d,the disappearance time of peritoneal irritation sign was(3.14±0.65)d and the hospitalization time was(15.41±2.16)d,which were shorter than(3.91±0.68),(4.82±0.71)and(20.82±3.59)d in the control group(P＜0.05).After treatment,ET-1,vWF:Ag and VEGF in both groups were lower than those before treatment;the observation group had ET-1 of(32.10±3.08)pg/ml,vWF:Ag of(121.42±18.75)%and VEGF of(134.68±28.79)pg/ml,which were lower than(40.78±3.18)pg/ml,(146.68±20.74)%and(162.47±41.25)pg/ml in the control group(P＜0.05).After treatment,the urinary RBP and UNAG levels in both groups were lower than those before treatment;the observation group had urinary RBP of(0.71±0.46)μg/ml and UNAG of(1.01±0.52)U/g·Cr,which were lower than(1.62±0.51)μg/ml and(1.46±0.55)U/g·Cr in the control group(P＜0.05).After treatment,the serum levels of CRP,TNF-α and IL-2 in both groups were lower than those before treatment;the observation group had serum CRP of(8.51±1.23)mg/L,TNF-α of(2.18±0.45)pg/ml and IL-2 of(6.53±1.08)pg/ml,which were lower than(13.48±2.58)mg/L,(3.06±0.52)pg/ml and(10.74±1.16)pg/ml in the control group(P＜0.05).Conclusion HP+CVVH has achieved good results in the treatment of patients with severe acute pancreatitis and acute renal injury,which can improve the vascular endothelial function and renal tubular function of patients,reduce the inflammatory response of the body,and promote the recovery of patients as soon as possible,which is worthy of application.
NETL
NSTL
万方数据
维普
