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目的：研究连续性肾替代治疗（ＣＲＲＴ）对外周血中肿瘤坏死因子（ＴＮＦ），白细胞介素１β（ＩＬ１β），白细胞介素８（ＩＬ８）和内皮衍生血管舒张因子（一氧化氮，ＮＯ）浓度的影响。方法：９例重症急性肾衰（ＡＲＦ）患者在明确诊断之后行ＣＲＲＴ，每天持续１０～１２ｈ。采用动静脉内瘘或中心静脉留置单针双腔导管建立血管通路，ＡＫ１０血泵建立体外循环，血滤器采用ＦＨ６６Ｄ型（聚酰胺膜，０６ｍ２）。治疗前和治疗１ｈ，２ｈ，３ｈ，６ｈ，９ｈ和１２ｈ（或结束时）取血和超滤液检测ＴＮＦ，ＩＬ１β，ＩＬ８和ＮＯ的浓度。结果：９例患者均存活且脱离肾脏替代治疗。四种细胞因子在超滤液中均未能检出。ＣＲＲＴ开始１ｈ后外周血中ＴＮＦ浓度轻度升高，但在治疗过程中缓慢降低，６ｈ时达到最低水平，与治疗前和治疗１ｈ相比差异显著（１０６４±５２２ｎｇ／Ｌ比１６７８±７８９ｎｇ／Ｌ和１７２２±７３５ｎｇ／Ｌ，Ｐ值分别＜００５和＜００１），随后直到１２ｈ时，其浓度基本稳定无显著变化；ＩＬ１β水平在治疗后有下降趋势，６ｈ降至最低值，但与治疗前相比差异不显著，６～１２ｈ间有所回升，ＩＬ８浓度也呈同样变化趋势。ＮＯ水平在ＣＲＲＴ开始后亦缓?
Objective: To investigate the effect of continuous renal replacement therapy (CRRT) on tumor necrosis factor (TNF), interleukin1β (IL1β), interleukin8 (IL8) and endothelium-derived vasodilator Nitric oxide, NO) concentrations. Methods: Nine patients with severe acute renal failure (ARF) underwent CRRT after a definite diagnosis, lasting 10-12 hours daily. Arteriovenous fistula or central venous catheter placement of single-needle double-lumen catheter to establish vascular access, AK 10 blood pump to establish cardiopulmonary bypass, FH66D type blood filter (polyamide membrane, 0.6m2). Before treatment and treatment 1h, 2h, 3h, 6h, 9h and 12h (or at the end of) and blood and ultrafiltrate detection of TNF, IL 1β, IL 8 and NO concentrations. Results: All 9 patients survived and were out of renal replacement therapy. Four kinds of cytokines in the ultrafiltrate were not detected. The level of TNF in peripheral blood increased slightly 1 h after CRRT, but decreased slowly during the course of treatment and reached the lowest level at 6 h after CRRT, which was significantly different from that before treatment and at 1 h (1064 ± 522 ng / L vs 1678 ± 789 ng / L And 1722 ± 735ng / L respectively, P values were <005 and <001, respectively. After 12h, the concentration of IL1β had no significant change. The level of IL1β decreased after treatment and dropped to the lowest value at 6h , But no significant difference compared with before treatment, 6 ~ 12h have been picked up, IL 8 concentrations also showed the same trend. NO levels also slow down after the start of CRRT?