连续性肾脏替代治疗联合血液灌流对脓毒症急性肾损伤患者的疗效

doi:10.16352/j.issn.1001-6325.2026.02.0267

基础医学与临床 ›› 2026, Vol. 46 ›› Issue (2): 267-272.doi: 10.16352/j.issn.1001-6325.2026.02.0267

连续性肾脏替代治疗联合血液灌流对脓毒症急性肾损伤患者的疗效

陶宁宁^*, 王海超, 苏月琴

宁夏银川市第一人民医院急诊科,宁夏银川 750200

收稿日期:2025-01-17 修回日期:2025-04-29 出版日期:2026-02-05 发布日期:2026-01-21
通讯作者: ^* chenyunzhen703961@163.com

Efficacy of continuous renal replacement therapy combined with hemoperfusion in sepsis patients with acute kidney injury

TAO Ningning^*, WANG Haichao, SU Yueqin

Department of Emergency, Yinchuan First People's Hospital, Yinchuan 750200, China

Received:2025-01-17 Revised:2025-04-29 Online:2026-02-05 Published:2026-01-21
Contact: ^* chenyunzhen703961@163.com

摘要/Abstract

摘要： 目的观察连续性肾脏替代治疗(CRRT)联合血液灌流(HP)治疗脓毒症急性肾损伤患者的疗效及对炎性反应指标PCT、CRP、HMGB1等的影响。方法选取银川市第一人民医院2023年3月至2024年3月收治的脓毒症急性肾损伤患者60例,根据随机数字表法分为接受CRRT治疗的对照组,CRRT联合HP治疗的观察组,各30例。统计两组患者序贯器官衰竭评分(SOFA)、血清肌酐(Scr)、尿素氮(BUN)、PCT、CRP、HMGB1水平、急性生理学及慢性健康状况评分系统(APACHEⅡ)评分变化,并记录28 d病亡率。结果与对照组相比,治疗后观察组Scr、BUN水平及APACHE Ⅱ评分明显下降(P＜0.05);观察组炎性因子PCT、HMGB1、IL-6水平明显降低(P＜0.05);观察组住院时间分别为(14.4±3.4)vs(22.5±5.3)d,机械通气时间(9.4±2.2)vs(14.6±3.1)d,观察组28 d病亡率更低(3.33% vs 20.00%,P＜0.05);观察组患者整体疗效更好(93.33% vs 73.33%,P＜0.05)。结论 CRRT联合HP治疗脓毒症急性肾损伤减轻患者炎症反应,促进肾功能恢复,降低28 d病亡率,提高整体疗效。

关键词: 连续性肾脏替代治疗, 血液灌流, 脓毒症, 急性肾损伤, 降钙素原

Abstract: Objective To investigate the efficacy of continuous renal replacement therapy combined with hemoperfusion in treating sepsis patients with acute kidney injury and its effect on inflammatory markers PCT, CRP and HMGB1. Methods From March 2023 to March 2024,60 patients with sepsis-induced acute kidney injury admitted to Yinchuan First People's Hospital were selected. According to the random number table method, they were divided into a control group receiving CRRT treatment and an observation group receiving CRRT combined with HP treatment, with 30 cases in each group. The sequential organ failure assessment score, levels of serum creatinine (Scr), urea nitrogen (BUN), PCT, CRP, HMGB1, acute physiology and chronic health evaluation Ⅱ score were observed in the two groups, and the 28-day mortality rate was recorded. Results Compared with the control group: after treatment, the renal function indexes Scr, BUN levels and APACHE Ⅱ scores of the observation group were significantly decreased (P＜0.05); The levels of inflammatory factors PCT, HMGB1 and IL-6 in the observation group were significantly decreased (P＜0.05). The hospitalization time of the observation group was (14.4±3.4) vs (22.5±5.3)d, the mechanical ventilation time was (9.4±2.2) vs (14.6±3.1)d, and the 28-day mortality rate in observation group was lower (3.33% vs 20.00%, P＜0.05). The overall efficacy of the observation group was better (93.33% vs 73.33%, P＜0.05). Conclusions CRRT combined with HP in treating sepsis with acute kidney injury can reduce the inflammatory response, promote the recovery of renal function, reduce the 28-day mortality rate, and improve the overall efficacy.

Key words: continuous renal replacement therapy, hemoperfusion, sepsis, acute kidney injury, procalcitonin

中图分类号:

R459.7

陶宁宁, 王海超, 苏月琴. 连续性肾脏替代治疗联合血液灌流对脓毒症急性肾损伤患者的疗效[J]. 基础医学与临床, 2026, 46(2): 267-272.

TAO Ningning, WANG Haichao, SU Yueqin. Efficacy of continuous renal replacement therapy combined with hemoperfusion in sepsis patients with acute kidney injury[J]. Basic & Clinical Medicine, 2026, 46(2): 267-272.

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连续性肾脏替代治疗联合血液灌流对脓毒症急性肾损伤患者的疗效

Efficacy of continuous renal replacement therapy combined with hemoperfusion in sepsis patients with acute kidney injury

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