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目的观察早期高容量血液滤过(HVHF)对多器官功能障碍综合征(MODS)及中性粒细胞(PMN)功能的影响。方法19头猪在失血性休克+内毒素双重打击后,随机分为对照组(n=9)和治疗组(HF组,n=10)。HF组在内毒素注射完后1h开始HVHF,每次滤过12h,连续3d。检测血中TNF-α、IL-1β和PMN呼吸爆发值的变化,并观察动物MODS发生率和病死率。结果HF组在HVHF治疗后血浆炎症介质浓度显著低于对照组;PMN呼吸爆发值未出现显著下降;动物MODS发生率和病死率显著低于对照组。结论早期HVHF能有效清除循环中过量的炎症介质,稳定PMN功能,改善机体免疫功能,对MODS有明显防治作用。
Objective To observe the effect of early high volume hemofiltration (HVHF) on the function of multiple organ dysfunction syndrome (MODS) and neutrophil (PMN). Method 19 pigs were randomly divided into control group (n = 9) and treatment group (HF group, n = 10) after hemorrhagic shock + endotoxin double stroke. The HF group started HVHF at 1h after endotoxin injection and was filtered for 12h each time for 3 consecutive days. The changes of respiratory burst value of TNF-α, IL-1β and PMN in blood were detected, and the morbidity and mortality of MODS were observed. Results The concentration of inflammatory mediators in HF group after HVHF treatment was significantly lower than that in control group. The PMN respiratory burst value did not decrease significantly. The morbidity and mortality of MODS in HF group were significantly lower than those in control group. Conclusion Early HVHF can effectively eliminate excessive inflammatory mediators in circulation, stabilize PMN function, improve immune function and have obvious preventive and therapeutic effects on MODS.