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目的:比较连续性血液净化与控温毯治疗重度中暑患者的疗效。方法:根据随机数字表法将30例重度中暑患者分为观察组和对照组,每组15例。观察组患者采用连续性血液净化降温,对照组采用控温毯降温,观察2组治疗后1、2、3、6h直肠温度下降情况;流式细胞仪检测治疗后0、1、3、6 h白细胞值、ELISA法检测白细胞NF-κB蛋白、血清C反应蛋白、降钙素原;Western blot法检测白细胞热休克蛋白70(Hsp70)表达。结果:观察组直肠温度下降幅度大于对照组(P<0.05);白细胞、C反应蛋白、降钙素原、NF-κB蛋白下降幅度大于对照组(P<0.05),观察组白细胞HSP70蛋白表达水平高于对照组(P<0.05)。结论:连续性血液净化用于重度中暑降温效果优于控温毯降温法,其机制可能为降低血清炎症指标、升高白细胞HSP70蛋白表达。
Objective: To compare the efficacy of continuous blood purification and temperature-controlled blanket in the treatment of severe heat stroke. Methods: According to the random number table method, 30 cases of severe heat stroke were divided into observation group and control group, 15 cases in each group. The patients in the observation group were treated with continuous blood purification and the control group was used to cool the temperature-controlled blanket. The rectal temperature was decreased at 1, 2, 3 and 6 hours after the treatment in both groups. Flow cytometry was used to detect the rectal temperature after 0, 1, Leucocyte and leucocyte NF-|ÊB protein, serum C-reactive protein and procalcitonin were determined by ELISA. Western blot was used to detect the expression of heat shock protein 70 (Hsp70). Results: The decrease of rectal temperature in the observation group was greater than that in the control group (P <0.05). The decrease of leukocyte, C-reactive protein, procalcitonin and NF-κB protein in the observation group was greater than that in the control group (P <0.05) Higher than the control group (P <0.05). CONCLUSION: Continuous blood purification is more effective than temperature-controlled blanket cooling in severe heat stroke. Its mechanism may be to reduce serum inflammation and increase leukocyte HSP70 protein expression.