Effects of adsorption combined with continuous venovenous hemofiltration on the serum inflammatory mediators levels in systemic inflammatory response syndrome patients

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Objective To discuss the effects of adsorption (AP) combined with continuous venovenous hemofiltration (CVVH) on the serum inflammatory mediators levels in systemic inflammatory response syndrome (SIRS) patients.Methods Sixty-three SIRS patients were divided into treatment group (31 cases,AP combined with CVVH ) and control group (32 cases,CVVH ) by random digits table method.The changes of the serum tumor necrosis factor-alpha (TNF-α ),C-reactive protein (CRP),interleukin (IL)-1,IL-6 and IL-10 before and after treatment were compared in two groups.Results There was no significant difference in the serum TNF-α,CRP,IL-1,IL-6,IL-10 before treatment between two groups (P ＞ 0.05 ).The serum TNF- α,CRP,IL- 1,IL-6,IL- 10 decreased after 2,26 and 50 h treatment compared with those before treatment in treatment group[after 2 h treatment:(226.4 ± 27.6) ng/L,(70.4 ± 22.1 ) mg/L,(30.1 ±2.9) ng/L,(227.5 ± 13.2) ng/L,(40.0 ±5.2) ng/L; after 26 h treatment:(165.3 ±24.5) ng/L,(58.2 ±25.1) mg/L,(18.2 ±2.7) ng/L,(82.4 ±7.2) ng/L,(26.2 ±4.3) ng/L; after 50 h treatment:( 120.6 ± 19.2) ng/L,(46.2 ± 24.6) mg/L,( 12.4 ± 2.3 ) ng/L,(38.1 ± 4.4 ) ng/L,( 15.2 ± 2.1 ) ng/L; before treatment:(350.8 ± 40.2) ng/L,( 126.4 ± 34.6) mg/L,(38.2 ± 3.6) ng/L,(307.7 ± 15.1 ) ng/L,(60.2 ± 9.3)ng/L,P ＜0.05].The serum TNF-α,CRP,IL-1,IL-6,IL-10 decreased after 26 and 50 h treatment compared with those before treatment in control group [after 26 h treatment:(262.7 ± 29.4) ng/L,(86.4 ±23.7) mg/L,(29.6 ± 3.1) ng/L,( 175.0 ± 10.6) ng/L,(42.7 ± 5.4) ng/L; after 50 h treatment:(219.3 ±25.6 ) ng/L,(75.6 ± 24.0) mg/L,(23.5 ± 2.8 ) ng/L,(99.0 ± 8.2 ) ng/L,(29.3 ± 4.8 ) ng/L; before treatment:(352.5 ± 40.4) ng/L,( 123.2 ± 35.2) mg/L,(37.5 ± 3.8) ng/L,(308.2 ± 15.3) ng/L,(58.4 ± 8.8) ng/L,P ＜0.05].There were significant differences in the serum TNF- α,CRP,IL-1,IL-6,IL-10 after 2,26 and 50 h treatment between two groups (P ＜ 0.05).Conclusion AP combined with CVVH can effectively decrease the serum inflammatory mediators in SIRS patients and it's therapeutic effect is superior to mere CVVH. Key words: Adsorption; Hemofiltration; Systemic inflammatory response syndrome; Inflammatory mediator