[摘要]目的 探討持续床旁肾替代疗法（CRRT）对重症胰腺炎（SAP）患者血清炎症因子水平及肾功能指标的影响。方法 选取2015年5月～2019年5月于我院就诊的82例SAP患者为研究对象，按随机数字表法分为A组（n=41）、B组（n=41）。A组进行常规治疗+CRRT，B组进行常规治疗。比较两组临床效果、炎症因子、肾功能。结果 A组治疗总有效率为92.86%，高于B组的76.19%，差异有统计学意义（P<0.05）;A组白介素-6（IL-6）、C反应蛋白（CRP）水平低于B组，差异有统计学意义（P<0.05）;A组血淀粉酶、尿素氮、肌酐水平分别为（512.37±47.24）U/L、（6.18±2.17）μmol/L、（125.42±54.96）mmol/L，B组分别为（683.49±83.10）U/L、（8.63±2.48）μmol/L、（336.67±64.85）mmol/L，A组的血淀粉酶、尿素氮水平、肌酐水平低于B组，差异均有统计学意义（P<0.05）。结论 SAP患者使用CRRT治疗效果显著，可改善肾功能，清除机体炎症介质，改善预后。

[关键词]重症胰腺炎;持续床旁肾替代疗法;炎症因子;肾功能

[中图分类号] R576          [文献标识码] A          [文章编号] 1674-4721（2020）7（c）-0047-03

Effect of continuous bedside renal replacement therapy on serum inflammatory factors and renal function in patients with severe pancreatitis

YOU Guo-ping

Department of Emergency， South Hospital of Fujian Provincial Hospital， Fujian Province， Fuzhou   350001， China

[Abstract] Objective To investigate the effect of continuous bedside renal replacement therapy （CRRT） on serum inflammatory factors and renal function in patients with severe pancreatitis （SAP）. Methods From May 2015 to May 2019， 82 patients with SAP treated in our hospital were selected as the study objects， and divided into group A （n=41） and group B （n=41） according to the random number table method. Group A received routine treatment+CRRT， group B received routine treatment. The clinical efficacy， inflammatory factors and renal function of the two groups were compared. Results The total effective rate of treatment in group A was 92.86%， higher than 76.19% in group B， the difference was statistically significant （P<0.05）; the levels of interleukin-6 （IL-6） and creactive protein （CRP） in group A were lower than those in group B， the differences were statistically significant （P<0.05）; the levels of serum amylase， urea nitrogen and creatinine in group A were （512.37±47.24） U/L， （6.18±2.17） μmol/L， （125.42±54.96） mmol/L， respectively， and those in group B were （683.49±83.10） U/L， （8.63±2.48） μmol/L， （336.67±64.85） mmol/L， the levels of serum amylase and urea nitrogen creatinine level and in group A were lower than those in group B， the differences were statistically significant （P<0.05）. Conclusion CRRT can improve renal function， remove inflammatory mediators and improve prognosis in patients with SAP.

[Key words] Severe pancreatitis; Continuous bedside renal replacement therapy; Inflammatory factors; Renal function

重症胰腺炎（SAP）具有病情凶险、进展迅速等特点，表现为腹痛，持续时间较长，并引起恶心、呕吐、腹泻、发热等症状，若早期不给予正确且有效治疗，可导致患者死亡，预后较差[1-2]。SAP发生与炎性因子释放、免疫损伤、微循环障碍、肾毒素累积等因素有关[3]。持续床旁肾替代疗法（CRRT）可高效清除机体毒素和炎症因子，并能纠正酸碱失衡和电解质紊乱，有安全、操作简单、疗效显著等优点，逐渐被应用SAP治疗[4]。本研究分析CRRT对SAP患者血清炎症因子水平及肾功能指标的影响，现报道如下。

1资料与方法

1.1 一般资料

选取2015年5月～2019年5月于我院就诊的82例SAP患者为研究对象，按随机数字表法分为A组（n=41）、B组（n=41）。本研究经我院医学伦理委员会审核批准。纳入标准：患者符合SAP相关诊断标准[5];患者家属签署知情同意书;患者急性生理学和慢性健康状况评估Ⅱ（APACHEⅡ）评分≥8分;患者出现多脏器功能障碍、全身炎症反应综合征。排除标准：精神功能障碍;意识不清;免疫系统异常;血液系统疾病;胰腺癌;肝、肾等重要脏器功能不全者。……