连续血液净化联合还原型谷胱甘肽对重症脓毒症休克肝损伤患者炎性介质水平及预后的影响
Effects of Continuous Blood Purification Combined with Reduced Glutathione on Levels of Inflammatory Mediators and Prognosis in Patients with Liver Injury Induced by Severe Septic Shock
郑燕1
作者信息
- 1. 上饶市立医院重症医学科 江西 上饶 334000
- 折叠
摘要
目的:探讨连续血液净化联合还原型谷胱甘肽对重症脓毒症休克肝损伤患者炎性介质水平及预后的影响.方法:选取 2020 年 1 月—2023 年 4 月上饶市立医院收治的重症脓毒症休克肝损伤患者80 例,随机将患者分为血液净化组和联合组,每组 40 例.血液净化组采用连续血液净化治疗,联合组在血液净化组的基础上联合还原型谷胱甘肽进行治疗.比较血液净化组和联合组患者治疗总有效率,炎症相关指标[白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)],免疫功能(CD4+、CD8+)及肝功能[谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)].结果:治疗后,联合组患者治疗总有效率高于血液净化组,差异有统计学意义(P<0.05);与治疗前比较,治疗后血液净化组和联合组患者IL-1、IL-6、TNF-α水平均降低,且联合组患者IL-1、IL-6、TNF-α水平均低于血液净化组,差异均有统计学意义(P<0.05);与治疗前比较,治疗后血液净化组和联合组患者CD4+水平均升高,CD8+水平均降低,联合组患者CD4+水平高于血液净化组,CD8+水平低于血液净化组,差异均有统计学意义(P<0.05);与治疗前比较,治疗后血液净化组和联合组患者ALT、AST、TBIL水平均降低,联合组患者ALT、AST、TBIL水平均低于血液净化组,差异均有统计学意义(P<0.05).结论:连续血液净化联合还原型谷胱甘肽能够提高重症脓毒症休克肝损伤患者治疗有效率,降低炎症水平,提高患者免疫功能,改善患者的肝功能.
Abstract
Objective:To explore the effects of continuous blood purification combined with Reduced Glutathione on levels of inflammatory mediators and prognosis in patients with liver injury induced by severe septic shock.Method:A total of 80 patients with liver injury induced by severe septic shock admitted to Shangrao Municipal Hospital from January 2020 to April 2023 were enrolled and randomly divided into blood purification group and combination group,with 40 cases in each group.The blood purification group was treated with continuous blood purification,while combination group was additionally treated with Reduced Glutathione on the basis of blood purification group.The total effective rate of treatment,inflammatory indexes[interleukin-1(IL-1),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],immune function indexes(CD4+,CD8+)and liver function indexes[alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL)]were compared between the two groups before and after treatment.Result:After treatment,the total effective rate of treatment in combination group was higher than that in blood purification group,the difference was statistically significant(P<0.05).Compared with pre-treatment,after treatment,levels of IL-1,IL-6 and TNF-α in both groups were decreased,those in combination group were lower than those in blood purification group,the differences were statistically significant(P<0.05).Compared with pre-treatment,after treatment,CD4+ levels were increased,while CD8+ levels were decreased in both groups,CD4+ level in combination group was higher than that in blood purification group,while CD8+ level was lower than that in blood purification group,the differences were statistically significant(P<0.05).Compared with pre-treatment,after treatment,levels of ALT,AST and TBIL in both groups were decreased,those in combination group were lower than those in blood purification group,the differences were statistically significant(P<0.05).Conclusion:Continuous blood purification combined with Reduced Glutathione can improve response rate of treatment,reduce inflammation level,enhance immune function,improve liver function in patients with liver injury induced by severe septic shock.
关键词
连续血液净化/还原型谷胱甘肽/重症脓毒症休克肝损伤/炎性介质Key words
Continuous blood purification/Reduced Glutathione/Liver injury induced by severe septic shock/Inflammatory mediator引用本文复制引用
基金项目
江西省卫生健康委科技项目(202312333)
出版年
2024
国家科技期刊平台
NSTL
万方数据