| 摘要: |
| 目的:探讨甲泼尼龙联合连续性血液净化(CBP)治疗儿童重症脓毒症的疗效及对患儿血清降钙素原(PCT)、N 前端脑钠 肽(NT-proBNP)的影响。 方法:选择我院 2021 年 5 至 2024 年 4 月收治的重症脓毒症患儿 150 例,分为甲泼尼龙+CBP 组和 CBP 组各 75 例,CBP 组单独用 CBP 治疗,甲泼尼龙+CBP 组联合使用甲泼尼龙和 CBP 治疗。 比较两组患儿的临床疗效、病情改善情 况[急性生理学及慢性健康状况评分Ⅱ(APACHEⅡ)和序贯器官衰竭评分( SOFA)]、炎症因子( IL-6、CRP、IL-10、IL-8)、血清 PCT、NT-proBNP 水平和血流动力学指标[心率(HR)、呼吸频率(RR)、平均动脉压(MAP)]和不良反应。 结果:治疗后,甲泼尼 龙+CBP 组总有效率为 92. 00%,高于 CBP 组的 78. 67%(P<0. 05);两组患儿 APACHEⅡ评分、SOFA 评分、PCT、NT-proBNP、HR、 RR、IL-6、CRP、IL-10、IL-8 水平均降低,且甲泼尼龙+CBP 组低于 CBP 组(P<0. 05);MAP 升高,且甲泼尼龙+CBP 组高于 CBP 组 (P<0. 05)。 两组患儿不良反应发生率比较差异无统计学意义(P>0. 05)。 结论:甲泼尼龙联合 CBP 治疗儿童重症脓毒症疗效 更好,能降低炎症因子及血清 PCT、NT-proBNP 水平。 |
| 关键词: 甲泼尼龙 连续性血液净化 重症脓毒症 降钙素原 N 前端脑钠肽 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2026.03.006 |
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| 基金项目:2024 年度河北省医学科学研究课题计划,编号 20241319。 |
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| Efficacy of Methylprednisolone Combined with Continuous Blood Purification in the Treatment of Severe Sepsis in Children |
| Song Danyang, Xu Pingping, Wang Xia, Li Hui, Li Xiao, Li Chuanlong |
| (Cangzhou Central Hospital, Hebei Cangzhou 061000, China) |
| Abstract: |
| Objective: To probe into the efficacy of methylprednisolone combined with continuous blood purification ( CBP) in the treatment of severe sepsis in children and its effects on serum procalcitonin ( PCT) and N-terminal pro-brain natriuretic peptide (NT-proBNP) in children. Methods: Totally 150 children with severe sepsis admitted into our hospital from May 2021 to Apr. 2024 were extracted to be divided into the methylprednisolone+CBP group and CBP group, with 75 cases in each group. The CBP group was treated with CBP alone, while the methylprednisolone + CBP group received methylprednisolone combined with CBP. The clinical efficacy, improvement of disease condition such as Acute Physiology and Chronic Health EvaluationⅡ (APACHEⅡ) and Sequential Organ Failure Assessment ( SOFA) scores, inflammatory factors such as IL-6, CRP, IL-10 and IL-8, serum levels of PCT and NT-proBNP, hemodynamic indicators such as heart rate ( HR), respiratory rate ( RR), and mean arterial pressure ( MAP ), and adverse drug reactions of two groups were compared. Results: After treatment, the total effective rate of methylprednisolone+CBP group was 92. 00%, higher than 78. 67% of CBP group ( P < 0. 05). After treatment, the APACHE Ⅱ scores, SOFA scores, PCT, NT-proBNP, HR, RR, IL-6, CRP, IL-10, IL-8 levels decreased in both groups, and the methylprednisolone+CBP group was lower than the CBP group (P<0. 05), while MAP levels of two groups increased, and the methylprednisolone+CBP group was higher than the CBP group (P<0. 05). There was no significant difference in the incidence of adverse drug reactions between two groups (P>0. 05). Conclusion: The efficacy of methylprednisolone combined with CBP in the treatment of severe sepsis in children is significant, which can reduce the levels of inflammatory factors and serum PCT and NT-proBNP. |
| Key words: ]methylprednisolone continuous blood purification severe sepsis procalcitonin N-terminal pro-brain natriuretic peptide |
