Effects of CRRT combined with Rhubarb at early stage on inflammatory cytokine among patients with severe acute pancreatitis / 重庆医学

ABSTRACT

Objective To investigate the effect of continuous renal replacement therapy (CRRT) combined with Rhubarb at early stage on inflammatory cytokine in the treatment of severe acute pancreatitis.Methods Fifty two patients with SAP were randomly divided into three groups,the conventional treatment group,the CRRT group,and the combined group.CRRT was inplemented in 48 h after the diagnosis of SAP.APACHE-Ⅱ score,mortality were compared before and after treatment.Double sandwich ELISA method was used to detect the levels of interleukin 22 (IL 22),IL-18 and tumor necrosis factor α(TNF-α).Results The clinical effect in combined group was better than other groups,and the mortality was lower than other groups,but the difference was not statisticaly different(P＞0.05).The levels of IL-22,TNF-α and IL-18 were not significantly different among three groups before treatment (P＞0.05).After treatment,the inflammatory factors decreased in all groups.The levels of IL-18,TNF-and IL-22 in CRRT group and combined group were significantly lower than those in control group (P＜0.05),and the combined group decresed most abviously(P＜0.05).There was no significant difference in APACHE Ⅱ score among the three groups before treatment (P＞0.05),while the APACHE-Ⅱ scores were significantly decreased after treatment,the difference was statistically significant (P＜0.05).After treatment,the APACHE-Ⅱ score of the combined group were significantly lower than the other two groups(P＜0.05).Conclusion The therapy of CRRT combined with Rhubarb at early period in SAP patients can better clean up inflammatory cytokines of IL-22,TNF-,IL-18,so that patients with SAP can get more clinical benefits.