Effect of hemoperfusion combined with hemofiltration on inflammatory reaction of hyperlipidemia severe acute pancreatitis_West China Medical Journal

Authors：

PAN Xuedong , CHEN Yi ,  QIAO Zhenguo

Department of Gastroenterology, Affiliated Wujiang Hospital of Nantong University, Suzhou, Jiangsu 215200, P. R. China;

Corresponding?author：

QIAO Zhenguo, Email: qzg66666666@163.com

Keywords：

Hemoperfusion; Hemofiltration; Hyperlipidemia; Pancreatitis; Inflammatory mediators

DOI：

10.7507/1002-0179.201509202

Video：

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Objective To study the clinical protective effect of hemoperfusion combined with hemofiltration on inflammatory reaction of hyperlipidemia severe acute pancreatitis (HLSAP). Methods Thirty-seven patients with HLSAP treated between January 2012 and December 2014 were selected and divided into three groups based on different treatments. Thirteen patients were allocated into hemoperfusion combined with continuous veno-venous hemofiltration group (HP+CVVH group) and treated with hemoperfusion combined with hemofiltration; 11 patients were allocated into continuous veno-venous hemofiltration group (CVVH group) and treated with hemofiltration; and all the other patients were allocated into control group and treated with conventional treatment. The levels of blood triglyceride, C-reactive protein, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8) and acute physiology and chronic health evaluation (APACHE)Ⅱ score of the patients after treatment were observed. The hospital stay, organ dysfunction rate and mortality of the patients were measured. Results Compared with the control group, the levels of blood triglyceride, C-reactive protein, TNF-α, IL-6, IL-8 and APACHE Ⅱ score of the patients in the HP+CVVH group and CVVH group were both significantly reduced 72 hours after therapy (P<0.05). However, the levels of blood triglyceride, C-reactive protein, TNF-α, IL-6, IL-8 and APACHE Ⅱ score of the patients in the HP+CVVH group were significantly lower than those in the CVVH group at the same time point (P<0.05). The hospital stay of the patients in the HP+CVVH group and CVVH group was significantly shorter than that in the control group (P<0.05). Compared with the CVVH group, the hospital stay of patients in the HP+CVVH group was significantly shorter (P<0.05). There was no statistical difference in organ dysfunction rate and mortality among the three groups (P>0.05). Conclusion Hemoperfusion combined with hemofiltration is an effective method for HLSAP by cleaning the inflammatory mediators availably and inhibiting the excessive inflammatory reaction.

Citation： PANXuedong, CHENYi, QIAOZhenguo. Effect of hemoperfusion combined with hemofiltration on inflammatory reaction of hyperlipidemia severe acute pancreatitis. West China Medical Journal, 2017, 32(2): 169-173. doi: 10.7507/1002-0179.201509202 Copy

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2.	黃忠, 李智. 胸腔積液及高脂血癥對重癥急性胰腺炎發生的預測作用. 華西醫學, 2016, 31(1): 103-105.
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9.	Kirchhoff C, Biberthaler P, Mutschler WE,et al. Early down-regulation of the pro-inflammatory potential of monocytes is correlated to organ dysfunction in patients after severe multiple injury: a cohort study. Crit Care, 2009, 13(3): R88.
10.	Ramudo L, Manso A, Sevillano S,et al. Kinetic study of TNF-alpha production and its regulatory mechanisms in acinar cells during acute pancreatitis induced by bile-pancreatic duct obstruction. J Pathol, 2005, 206(1): 9-16.
11.	祝建紅, 陳衛昌, 葉建新. 沙利度胺對大鼠急性壞死性胰腺炎保護作用的實驗研究. 中華胰腺病雜志, 2011, 11(3): 203-206.
12.	Hong B, Ling Z, Songmin H,et al. Continuous venovenous hemofiltration and hemoperfusion in successful treatment of a patient with crush syndrome and acute pancreatitis. Ren Fail, 2012, 34(3): 383-386.
13.	Kielstein T, Burkhardt O. Dosing of antibiotics in critically ill patients undergoing renal replacement therapy. Curr Pharm Biotechnol, 2011, 12(12): 2015-2019.
14.	Malmstr?m ML, Hansen MB, Andersen AM,et al. Cytokines and organ failure in acute pancreatitis: inflammatory response in acute pancreatitis. Pancreas, 2012, 41(2): 271-277.
15.	張遠超, 喻莉, 耿峰, 等. 血液灌流聯合血液濾過治療高脂血癥性胰腺炎的效果觀察. 中華肝膽外科雜志, 2014, 20(4): 274-276.
16.	Yekebas F, Eisenberger F, Ohnesorge H,et al. Attenuation of sepsis-related immunoparalysis by continuous veno-venous hemofiltration in experimental porcine pancreatitis. Crit Care Med, 2001, 29(7): 1423-1430.

1. ?Xu C, Qiao Z, Lu Y,et al. Influence of fatty liver on the severity and clinical outcome in acute pancreatitis. PLoS One, 2015, 10(11): e0142278.
2. 黃忠, 李智. 胸腔積液及高脂血癥對重癥急性胰腺炎發生的預測作用. 華西醫學, 2016, 31(1): 103-105.
3. Tsuang W, Navaneethan U, Ruiz L,et al. Hypertriglyceridemic pancreatitis: presentation and management. Am J Gastroenterol, 2009, 104(4): 984-991.
4. 中華醫學會消化病學分會胰腺疾病學組, 《中華胰腺病雜志》編輯委員會, 《中華消化雜志》編輯委員會. 中國急性胰腺炎診治指南 (2013 年, 上海). 臨床肝膽病雜志, 2013, 29(9): 656-660.
5. 蘇軍凱, 李兆申. 血液凈化治療高脂血癥性胰腺炎研究進展. 胰腺病學, 2006, 6(5): 310-312.
6. Sun S, He L, Bai M,et al. High-volume hemofiltration plus hemoperfusion for hyperlipidemic severe acute pancreatitis: a controlled pilot study. Ann Saudi Med, 2015, 35(5): 352-358.
7. Tang Y, Zhang L, Fu P,et al. Hemoperfusion plus continuous veno-venous hemofiltration in a pregnant woman with severe acute pancreatitis: a case report. Int Urol Nephrol, 2012, 44(3): 987-990.
8. 方步武, 邱奇, 吳咸中, 等. 急腹癥并發多器官功能障礙綜合征細胞因子及炎癥介質與肽類激素的變化. 中國危重病急救醫學, 2003, 15(1): 19-22.
9. Kirchhoff C, Biberthaler P, Mutschler WE,et al. Early down-regulation of the pro-inflammatory potential of monocytes is correlated to organ dysfunction in patients after severe multiple injury: a cohort study. Crit Care, 2009, 13(3): R88.
10. Ramudo L, Manso A, Sevillano S,et al. Kinetic study of TNF-alpha production and its regulatory mechanisms in acinar cells during acute pancreatitis induced by bile-pancreatic duct obstruction. J Pathol, 2005, 206(1): 9-16.
11. 祝建紅, 陳衛昌, 葉建新. 沙利度胺對大鼠急性壞死性胰腺炎保護作用的實驗研究. 中華胰腺病雜志, 2011, 11(3): 203-206.
12. Hong B, Ling Z, Songmin H,et al. Continuous venovenous hemofiltration and hemoperfusion in successful treatment of a patient with crush syndrome and acute pancreatitis. Ren Fail, 2012, 34(3): 383-386.
13. Kielstein T, Burkhardt O. Dosing of antibiotics in critically ill patients undergoing renal replacement therapy. Curr Pharm Biotechnol, 2011, 12(12): 2015-2019.
14. Malmstr?m ML, Hansen MB, Andersen AM,et al. Cytokines and organ failure in acute pancreatitis: inflammatory response in acute pancreatitis. Pancreas, 2012, 41(2): 271-277.
15. 張遠超, 喻莉, 耿峰, 等. 血液灌流聯合血液濾過治療高脂血癥性胰腺炎的效果觀察. 中華肝膽外科雜志, 2014, 20(4): 274-276.
16. Yekebas F, Eisenberger F, Ohnesorge H,et al. Attenuation of sepsis-related immunoparalysis by continuous veno-venous hemofiltration in experimental porcine pancreatitis. Crit Care Med, 2001, 29(7): 1423-1430.

West China Medical Journal

Effect of hemoperfusion combined with hemofiltration on inflammatory reaction of hyperlipidemia severe acute pancreatitis

Abstract Full text Figures/Tables Video References Cited by

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