The Editorial Department of Chinese Journal of Clinical Research
Doi
Abstract
"Objective To analyze the effects of continuous renal replacement therapy（CRRT） dose on serum prostaglandin⁃2（PGE2）and intestinal fatty acid⁃binding protein（I⁃FABP）levels and prognosis in patients with severe sepsis，and to reveal the dynamic pattern of change. Methods A total of 115 patients with severe sepsis treated in Qianjiang Central Hospital of Chongqing from May 2021 to May 2024 were selected as the study subjects. They were divided into group A（38 cases），group B（37 cases）and group C（40 cases）. Group A，group B，and group C were given CRRT treatment doses of 20 mL/ （kg · h），40 mL/ （kg · h），and 60 mL/ （kg · h），respectively. After 7 days of treatment，enzyme⁃linked immunosorbent assay（ELISA）was used to detect intestinal mucosal barrier function indicators［endotoxin，diamine oxidase（DAO），D⁃lactic acid］as well as the levels of PGE2 and I⁃FABP. Flow cytometry was employed to measure immune function indicators（CD4 +，CD8 +，and CD4 +/CD8 +）. The Acute Physiology and Chronic Health Evaluation Ⅱ（APACHE Ⅱ）score and Sequential Organ Failure Assessment（SOFA）score were used to evaluate prognosis. Results After treatment，the levels of endotoxin，DAO，D⁃lactic acid，CD8 +，PGE2 and I⁃FABP in all groups were decreased，and which in group C were lower than those in group A and group B（P<0.05）. After treatment，the levels of CD4 + and CD4 +/CD8 + in all groups were increased，and the levels in group C were higher than those in group A and group B（P<0.05）. After treatment，APACHE Ⅱ and SOFA scores were decreased in all groups，and which in group C were lower than those in group A and group B（P<0.05）. Conclusion CRRT treatment with different doses can improve intestinal mucosal barrier function and immune function in patients with severe sepsis，reduce serum PGE2 and I ⁃ FABP levels，and the high ⁃ dose group achieves better therapeutic effects，which can improve patient prognosis.
