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投稿时间:2024-12-04 网络发布日期:2025-11-26
投稿时间:2024-12-04 网络发布日期:2025-11-26
中文摘要: 目的 分析连续性肾脏替代疗法(CRRT)治疗剂量对严重脓毒症患者血清前列腺素-2(PGE2)、肠型脂肪酸结合蛋白(I-FABP)表达水平及预后的影响,揭示其动态变化规律。方法 选取2021年5月至2024年5月在重庆大学附属黔江医院治疗的 115 例严重脓毒症患者进行研究,按照 CRRT 临床治疗剂量分为 3 组,A 组 38例,B 组 37 例,C组40例,A组给予治疗剂量25 mL/ (kg·h),B组给予治疗剂量30 mL/ (kg·h),C组给予治疗剂量35 mL/(kg·h)。治疗7 d后,采用酶联免疫吸附法(ELISA)检测肠黏膜屏障功能[内毒素、二胺氧化酶(DAO)、D-乳酸]和PGE2、I-FABP水平,采用流式细胞仪检测免疫功能(CD4+、CD8+及CD4+/CD8+),采用急性生理学及慢性健康状况(APACHE Ⅱ)评分、序贯器官衰竭评估(SOFA)评分评估预后。结果 治疗后,各组患者内毒素、DAO、D-乳酸、CD8+、PGE2、I-FABP 水平显著降低,且 C 组低于 A 组、B 组(P<0.05)。治疗后,各组患者 CD4+、CD4+/CD8+水平显著升高,且C组高于A组、B组(P<0.05)。治疗后,各组患者APACHE Ⅱ、SOFA评分显著降低,且C组低于A组、B组(P<0.05)。结论 严重脓毒症患者采用CRRT治疗,可改善患者肠黏膜屏障功能,降低血清PGE2、I-FABP水平,且大剂量患者治疗效果较好,可改善患者预后。
Abstract:Objective To analyze the effects of continuous renal replacement therapy(CRRT) dose on serum prostaglandin-2(PGE2)and intestinal fatty acid-binding protein(I-FABP)levels and prognosis in patients with severe sepsis,and to reveal the dynamic pattern of change. Methods A total of 115 patients with severe sepsis treated in Qianjiang Central Hospital of Chongqing from May 2021 to May 2024 were selected as the study subjects. They were divided into group A(38 cases),group B(37 cases)and group C(40 cases). Group A,group B,and group C were given CRRT treatment doses of 20 mL/ (kg · h),40 mL/ (kg · h),and 60 mL/ (kg · h),respectively. After 7 days of treatment,enzyme-linked immunosorbent assay(ELISA)was used to detect intestinal mucosal barrier function indicators[endotoxin,diamine oxidase(DAO),D-lactic acid]as well as the levels of PGE2 and I-FABP. Flow cytometry was employed to measure immune function indicators(CD4 +,CD8 +,and CD4 +/CD8 +). The Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score and Sequential Organ Failure Assessment(SOFA)score were used to evaluate prognosis. Results After treatment,the levels of endotoxin,DAO,D-lactic acid,CD8 +,PGE2 and I-FABP in all groups were decreased,and which in group C were lower than those in group A and group B(P<0.05). After treatment,the levels of CD4 + and CD4 +/CD8 + in all groups were increased,and the levels in group C were higher than those in group A and group B(P<0.05). After treatment,APACHE Ⅱ and SOFA scores were decreased in all groups,and which in group C were lower than those in group A and group B(P<0.05). Conclusion CRRT treatment with different doses can improve intestinal mucosal barrier function and immune function in patients with severe sepsis,reduce serum PGE2 and I - FABP levels,and the high - dose group achieves better therapeutic effects,which can improve patient prognosis.
keywords: Severe sepsis Continuous renal replacement therapy Therapeutic dose Prostaglandin⁃ 2 Intestinal fatty acid binding protein Intestinal mucosal barrier function Immune function Prognosis
文章编号: 中图分类号:R459.5 R631 文献标志码:A
基金项目:国家自然科学基金资助项目(81801956)
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引用文本:
肖惠,黎上琳,冯新程,童霞.不同CRRT治疗剂量对严重脓毒症患者血清PGE2和I⁃FABP水平及预后的影响[J].中国临床研究,2025,38(11):1675-1678,1684.
肖惠,黎上琳,冯新程,童霞.不同CRRT治疗剂量对严重脓毒症患者血清PGE2和I⁃FABP水平及预后的影响[J].中国临床研究,2025,38(11):1675-1678,1684.
