严重大面积烧伤连续血液净化对炎症介质的影响.pdfVIP

• 458 • 苏B良药 2007 年 5 月第 33 毯篮立组二 IianII: SU Med] , Mav 2007 , Vo133 , No.5 ·论著， 严重大面积烧伤连续血液净化对炎症 介质的影响 美合庆刘坤胡新宜解伟光汪罕汪 j闹别、东施陈一飞 E摘要】 固的 探讨连续血被净化CCBP) 对严重大面积烧伤患者静脉血中炎症介质 TNF-.o:、 IL-6 、 IL一 10 水平的影响。方法 12 例严3最大面积烧伤后接受 CBP 治疗的患者，分别于 CBP 治疗前 和治疗后 4 ， 8、 12 h 留取肝索拉凝静脉血 5ml，检测外周血白细胞分类计数和血浆中丁NF-o:， IL-6 和 IL-10水平。结果 CBP 开始治疗4h 内，患者 TNF-o:、 IL-6 和 IL-10 水平均有显著下降，但至 12 h 又 有所凹升。随着治疗进行，自细胞总数及中性粒细胞所占百分比与 CBP 治疗前比较均显著降低 (PO.O日。结论 CBP 可明踉减轻严重大面积烧伤患者白细胞应激状~，有效清除各种炎症介脆， 但需及时更换滤器，以维持疗效。 【关键词】 血液净化;烧伤;炎症介质 【中圈分类号】 R644 【文献标识码】 A (文章编号】 0253-3685 (2007) 05-0458-02 Effect of continuous bl，制xlp町ification on i时lannnatory factor四 in pa创ents with severe lar恕~ area b阳明 JING Huíqíng , LIU Kun , HU Xing归。， ， et al. Department of Burn and Plastic Surgery , Nanjing General Hospitα1 of Nanjing Military Command , Nanjing 210002 , CHINA (Abstract】 0时ective To investigate the dynamic changes of inflammatory factors in severe large area bum patients treated with cominuous blood purification(CBP). Meth侃ls Twelve severe patients with large burn area undergoing CBP were included in this study. Five ml venous samples were taken for the measurement of IL-6 ,TNF-o: and IL-10 by radioimmunoassay before CBP , at 4 , 8 and 12 h during CBP. 羽Thitc cell ∞unt was monitored as wel 1. Results During 4 h CBP ,the lcvcls of IL心， TNF-αand IL-10 were significantly decreased , which increased at 12 h. The perc巳ntage of neutrophil significantly decreased from 89. 81 土2. 86% (before CBP)ω76.64士8. 83%(at 72 h)(P 0.05). Conclusion C即 could decrease neutrophil counts in peripheral venous blood and eliminate inflammation factors effectively in severe large area burn paticnts. To keep thc efficient purification , the purification equiment should be char飞ged in time. [Key wo时sl