程骏章 胡守亮 卢宏柱 莫继安 艾俊英 刘俊成 袁凡丽 陈蓉

【摘要】目的 比较持续低效血液透析（sustained low-efficiency dialysis, SLED）与连续性血液净化（continuous blood purification, CBP）在危重症患者治疗效果中的差异。方法 将长江大学附属第一医院96例危重症患者按血液净化方式的不同分为连续性血液净化（CBP）组和持续低效血液透析（SLED）组，比较两种治疗方式治疗后各项生化指标、住院天数、血流动力学参数、急性生理学与慢性健康状况评分（acute physiology and chronic health evaluation, APACHE）Ⅱ以及存活率和病死率的差异。结果 两种血液净化方式治疗后，两组患者血清肌酸激酶同工酶（CK-MB）、肌酸激酶（CK）、肌酐（Cr）、谷草转氨酶（AST）、谷丙转氨酶（ALT）水平，1 d、 2d、和7d 的APACHE Ⅱ评分均低于治疗前水平，差异具有统计学意义（P＜0.05）；SLED组与CBP组比较，患者的住院天数、生化指标、APACHE Ⅱ评分、血流动力学参数以及存活率和病死率差异均无统计学意义（P＞0.05）。结论 SLED具有CBP相似的血流动力学稳定性，且两者在危重症患者中的治疗效果相当，SLED为临床治疗危重症提供了一种更经济方便的方式。

【关键词】持续低效血液透析；连续性血液净化；危重症；治疗效果

Compariron of the therapeutic effect between sustained low-efficiency dialysis (SLED) and continuous blood purification (CBP) in critically ill patients CHENG Jun-zhang, HU Shou-liang, LU Hong-zhu, MO Ji-an, AI Jun-ying, LIU Jun-cheng, YUAN Fan-li, CHEN Rong. Departmeng of Nephrology, First Affiliated Hospital, Yangtze University, Jingzhou 434000, China

Corresponding author: HU Shou-liang, Email: rqsm514@163.com

【Abstract】Objective To compare the therapeutic effec between sustained low-efficiency dialysis (SLED) and continuous blood purification (CBP) in critically ill patients. Methods According to the treatment ways, 96 critically ill patients were divided into SLED group and CBP group. A comparison was made on the biochemical indicators, in-hospital duration, hemodynamic parameters, acute physiology and chronic health evaluation (APACHE-Ⅱ), the survival and the mortality rates. Results After treatment, the levels of serum creatine kinase isozyme MB (CK-MB), creatine kinase (CK), creatinine (Cr), glutamic-oxalacetic transaminase (AST), glutamate-pyruvate transaminase (ALT), APACHE Ⅱ score on the 1st, 2nd and 7th day were lower than those prior to the treatment in both groups(P＜0.05). There were no statistical differences in in-hospital duration, biochemical indicators, APACHE Ⅱ score, hemodynamic parameters, the survival rate and the mortality rate between the two groups (P＞0.05). Conclusions SLED has similar hemodynamic stability with CBP, and the two methods have similar treatment effects in critically ill patients. However, SLED can be relatively economical and convenient for critically ill patients in clinical.

【Key words】Sustained low-efficiency dialysis; Continuous blood purificatin; Critically ill; Therapeutic effect

急危重症是严重威胁人类健康和导致患者死亡的重要原因。随着血液净化技术的不断发展与进步，其在临床中的应用也越来越普遍，且血液净化技术的应用范围也在不断扩大。连续性肾脏替代治疗（continuous renal replacement therapy, CRRT）即现在的连续性血液净化（CBP）仍然是治疗危重症患者的最普遍方式^［1］，其在临床中的应用已较成熟。本研究通过比较持续低效血液透析（SLED）与CBP在急危重症患者治疗效果中的差异，从而为临床探索一种新的治疗急危重症患者的血液净化方式。……