Effects of Continuous Renal Replacement Therapy on Serum Levels of IL-1,TNF-a,and CRP in Patients with Severe Acute Pancreatitis

Objective: To investigate the effects of continuous renal replacement therapy(CRRT) on the serum levels of interleukin-1(IL-1),tumor necrosis factor(TNF-a) and c-reactive protein(CRP) in patients with severe acute pancreatitis(SAP),and to explore the pathogenesis of SAP.Methods: Forty-three SAP patients hospitalized in intensive care unit(ICU) from March 2009 to December 2010 were randomly divided into treatment group(n=23) in which patients received conventional treatment and CRRT,and control group(n=20) in which patients received conventional treatment only.Plasma levels of TNF-a,IL-1,and CRP in 0,8,24,48,72 hours after treatment were observed and compared between the two groups.The hospitalizing days and fatality rates were recorded,and acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) scores were also recorded before and after treatment.Results: After treatment,hospitalizing days and fatality rate of treatment group were significantly lower than those of control group(P0.05).The APACHE Ⅱ scores in treatment group in 24 h,48 h and especially in 72 h after treatment were significantly lower than those in control group(P0.05).The Plasma levels of TNF-a,IL-1,and CRP were remarkably lower than those before treatment and than those of control group at the same time point(P0.05);Conclusions: CRRT can correct multiple organ dysfunction induced by SAP,prevent the occurrence of multi-organ failure,reduce mortality and increase survival rate of patients with SAP.