Curative effect of CRRT combined with plasma exchange in the treatment of hyperlipidemic severe acute pancreatitis

doi:10.11958/20221994

Abstract

Abstract:

Objective To analyze the curative effect of continuous renal replacement therapy (CRRT) combined with plasma exchange (PE) in patients with severe acute pancreatitis of hyperlipidemia. Methods According to different treatment methods, 109 patients with severe acute pancreatitis of hyperlipidemia were divided into the CRRT group (51 cases) and the combination group (CRRT combined with PE, 58 cases). The curative effect, disappearance time of symptoms and complications were compared between the two groups. The decline degree of triglyceride (TG) was calculated in the combination group after 72 h treatment. According to the decline degree of TG (60% as the limit), patients were divided into the high efficiency group (>60%, 37 cases) and the low efficiency group (≤60%, 21 cases). The influencing factors on the curative effect of CRRT combined with PE were analyzed by multivariate linear regression model. Results After 72 h of treatment, levels of total cholesterol (TC), TG, amylase (AMY), C-reactive protein (CRP) and procalcitonin (PCT) were lower in the combination group than those of the CRRT group (P < 0.05). The disappearance time of symptoms (abdominal pain, fever, nausea and vomiting), mechanical ventilation time and stay time in ICU were shorter in the combination group than those of the CRRT group (P < 0.05). Before treatment, levels of TC and TG were higher in the high efficiency group than those of the low efficiency group, while interval from onset to PE was shorter than that in the low efficiency group (P < 0.05). The results of multivariate linear regression analysis showed that the regression equation:TG decline =33.591+1.010×(TC before treatment)+2.088×(TG before treatment)-0.443×(interval from onset to PE). Conclusion CRRT combined with PE can effectively relieve symptoms, which is conducive to disease outcomes. The curative effect is related to TC and TG levels before treatment and the interval from onset to PE.

Key words: pancreatitis, acute hemorrhagic, hyperlipidemias, continuous renal replacement therapy, plasma exchange, linear models

CLC Number:

R576

Figures/Tables 8

References 19

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组别	n	年龄/岁	性别（男/女）	BMI/（kg/m²）	基础疾病/例			入住ICU 24 h APACHEⅡ/分	入住ICU 24 h SOFA/分
组别	n	年龄/岁	性别（男/女）	BMI/（kg/m²）	冠心病	高血压	糖尿病	入住ICU 24 h APACHEⅡ/分	入住ICU 24 h SOFA/分
CRRT组	51	42.14±9.82	22/29	23.46±3.10	2（3.92）	6（11.76）	4（7.84）	15.65±3.29	9.18±2.08
联合组	58	41.79±8.75	25/33	23.11±3.06	2（3.45）	7（12.07）	3（5.17）	15.38±2.98	8.90±1.98
t、χ²或P		0.194	0.000	0.589	1.000^▲	0.002	0.703^▲	0.446	0.720

组别	n	年龄/岁	性别（男/女）	BMI/（kg/m²）	基础疾病/例			入住ICU 24 h APACHEⅡ/分	入住ICU 24 h SOFA/分
组别	n	年龄/岁	性别（男/女）	BMI/（kg/m²）	冠心病	高血压	糖尿病	入住ICU 24 h APACHEⅡ/分	入住ICU 24 h SOFA/分
CRRT组	51	42.14±9.82	22/29	23.46±3.10	2（3.92）	6（11.76）	4（7.84）	15.65±3.29	9.18±2.08
联合组	58	41.79±8.75	25/33	23.11±3.06	2（3.45）	7（12.07）	3（5.17）	15.38±2.98	8.90±1.98
t、χ²或P		0.194	0.000	0.589	1.000^▲	0.002	0.703^▲	0.446	0.720

组别	n	年龄/岁	性别（男/女）	BMI/（kg/m²）	基础疾病/例			入住ICU 24 h APACHEⅡ/分	入住ICU 24 h SOFA/分
组别	n	年龄/岁	性别（男/女）	BMI/（kg/m²）	冠心病	高血压	糖尿病	入住ICU 24 h APACHEⅡ/分	入住ICU 24 h SOFA/分
高效组	37	41.05±8.26	14/23	22.86±3.56	1（2.70）	5（13.51）	2（5.40）	15.62±2.97	8.92±2.06
低效组	21	42.90±10.13	11/10	23.21±2.94	1（4.76）	2（9.52）	1（4.76）	14.81±3.80	8.38±1.66
t、χ²或P		0.755	1.155	0.379	1.000^▲	1.000^▲	1.000^▲	0.904	1.022

组别	n	年龄/岁	性别（男/女）	BMI/（kg/m²）	基础疾病/例			入住ICU 24 h APACHEⅡ/分	入住ICU 24 h SOFA/分
组别	n	年龄/岁	性别（男/女）	BMI/（kg/m²）	冠心病	高血压	糖尿病	入住ICU 24 h APACHEⅡ/分	入住ICU 24 h SOFA/分
高效组	37	41.05±8.26	14/23	22.86±3.56	1（2.70）	5（13.51）	2（5.40）	15.62±2.97	8.92±2.06
低效组	21	42.90±10.13	11/10	23.21±2.94	1（4.76）	2（9.52）	1（4.76）	14.81±3.80	8.38±1.66
t、χ²或P		0.755	1.155	0.379	1.000^▲	1.000^▲	1.000^▲	0.904	1.022

组别	n	WBC/（×10⁹/L）			PLT/（×10⁹/L）			HCT/%
组别	n	治疗前	治疗72 h	t	治疗前	治疗72 h	t	治疗前	治疗72 h	t
CRRT组	51	13.94±3.57	9.13±2.18	9.500^＊＊	262.03±36.58	253.87±19.69	1.642	33.73±3.47	39.47±3.30	9.946^＊＊
联合组	58	14.42±3.22	8.91±2.22	12.002^＊＊	256.21±40.55	250.36±18.12	1.187	33.13±3.32	40.15±3.17	16.700^＊＊
t		0.738	0.514		0.784	0.970		0.919	1.105