A clinical study on early blood purification in the treatment of patients with SIRS /sepsis

Objective To evaluate the effect of continuous blood purification (CBP)on cytokines and prognosis in the treatment of patients with SIRS/sepsis.MethodsE?7 patients diagnosed as SIRS and25 patients diagnosed as sepsis were treated with continuous blood purification for 24 hours. The serum levels of TNF-α, IL-1 and IL-6 in CBP group were detected at 0 h, and 6,12,24,36 h after CBP. APACHEⅡ, lactate and Pg-aCO2 were also tested. The survival rates of patients were compared between CBP group and control group. Results In SIRS group, the level of TNF-α was significantly lower at 6,24,36 h than that at 0 h( P0.05); the level of IL-1 was significantly lower at 36 h than that at 0 h( P0.05), and the level of IL-6 was significantly lower at 12,36 h than that at 0 h( P0.05). In sepsis group, there was a significant reduction of the levels of TNF-α and IL-6 at 36 h( P0.05), and the level of IL-6 was significantly lower at 12, 36 h than that at 0 h(P0.05). At 36 h, there was a significant difference of the levels of TNF-α, IL-1 and IL-6 between CBP group and control group( P0.05), and the level of TNF-α was lower in SIRS group than that in sepsis group. After CBP treatment, APACHEⅡ, lactate and Pg-aCO2 declined significantly in CBP group(P0.05). Compared with control group, the survival rates of CBP group was higher(62.90% vs 26.67.%,P0.05).ConclusionCBP is an effective therapy to remove the cytokines and improve the outcome of patients with SIRS/sepsis. The earlier to receiving CBP treatment, the better the outcome is.