JPS  >> Vol. 3 No. 2 (May 2015)

    Influence of Liver and Renal Function in Systemic Mild Hypothermia Technique to the Multiple Organ Dysfunction Syndrome in Children

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罗菲菲,李小双,解启莲,刘利,孙静敏,张美英,吴斌:安徽省儿童医院急救中心,安徽 合肥

多器官功能障碍综合征亚低温儿童肝肾功能Multiple Organ Dysfunction Syndrome Mild Hypothermia Children Liver and Renal Functions


目的:通过全身亚低温治疗多器官功能障碍综合征(MODS)患儿,探讨全身亚低温技术对MODS患儿肝肾功能的影响。方法:将36例患儿随机分为全身亚低温治疗组(亚低温组,HT组,19例)和常规治疗组(对照组,NT组,17例)。分别于亚低温治疗前及治疗后第12 h、24 h、36 h时间点采集外周静脉血检测并记录两组患儿肝肾功能的变化。结果:HT组与NT组治疗前丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)比较无统计学差异(P > 0.05);治疗后36 h ALT两组相比差异具有统计学意义(P < 0.05),且HT组明显优于NT组;治疗后36 h AST相比两组差异无统计学意义(P > 0.05)。HT组与NT组治疗前肌酐(CR)、尿素氮(BUN)比较无统计学差异(P > 0.05);治疗后36 h两组CR、BUN相比差异具有统计学意义(P < 0.05),且HT组明显优于NT组。结论:全身亚低温治疗对MODS患儿肝肾功能具有保护作用。

Objective: By observing systemic mild hypothermia technology in the multiple organ dysfunction syndrome (MODS) in children in the application, to investigate the effects of systemic mild hypo-thermia technology on liver and renal functions of MODS children. Methods: 36 cases of hospita-lized children MODS patients were randomly divided into systemic hypothermia group (HT) 19 patients and the control group (NT) 17 patients. The changes of liver and renal functions of the patients in each group were checked and recorded before and after 12 h, 24 h and 36 h periods in the low temperature. Results: There was no difference in the comparation of ALT, AST, CR and BUN in each time period between two groups (P > 0.05); the level of ALT, CR and BUN in 36 h had obvious statistical difference comparing to the before (P < 0.05), and the HT group than normal temperature NT group; while no significant difference compared to AST in 36 h. Conclusion: The systemic mild hypothermia had significant liver and renal function-protective effects in MODS children patients.

罗菲菲, 李小双, 解启莲, 刘利, 孙静敏, 张美英, 吴斌. 全身亚低温技术对多器官功能障碍综合征患儿肝肾功能的影响[J]. 生理学研究, 2015, 3(2): 9-14.


[1] Ward, P.A. (2004) The dark side of C5a in sepsis. Nature Reviews Immunology, 4, 133-142.
[2] 王超, 苏强, 张淑文, 等 (2009) 多器官功能障碍综合征诊断标准的多中心临床研究. 中华外科杂志, 1, 40-45.
[3] 邵肖梅, 周文浩, 程国强, 等 (2011) 亚低温治疗新生儿缺血缺氧性脑病方案. 中国循证儿科杂志, 5, 337-339.
[4] Dellinger, R.P., Levy, M.M., Rhodes, A., et al. (2013) Surviving sepsis campaign: International guidelines for management of severe sepsis and septic shock: 2012. Critical Care Medicine, 41, 580-637.
[5] Hypothermia after Cardiac Arrest Study Group (2002) Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. The New England Journal of Medicine, 346, 549-556.
[6] Bernard, S., Buist, M., Nontero, O., et al. (2003) Induced hypothermia using large volume, ice-cold intravenous fluid in comatose survivors of out-of hospital cardiac arrest: A preliminary report. Resuscitation, 56, 9-13.
[7] Vaquero, J., et al. (2007) Mild hypothermia attenuates liver injury and improves survival in mice with acetaminophen toxicity. Gastroenterology, 132, 372-383.
[8] Kyuseok, K. (2010) Induced hypothermia attenuates the acute lung injury in hemorrhagic shock. The Journal of Trauma Injury, Infection, and Critical Care, 68, 373-381.
[9] Gallardo, F., Gallardo Garcia, M.B., Cabra, M.J., et al. (2010) Nutrition and anaemias in critical illness. Nutrición Hospitalaria, 25, 99-106.
[10] 孙洪伟, 杨龙龙, 等 (2011) 脂氧素A4对急性坏死性胰腺炎诱发全身炎症反应综合征的调节. 中华实验外科杂志, 11, 2007-2008.
[11] Jiang, J.R. (1998) Basic and clinical research of mild hypothermia neuron protection. The Second Military Medical University Priniing Co., Shanghai, 3-7.
[12] 徐定银, 钱建中 (2006) 低温对急性胰腺炎鼠多脏器功能的影响. 浙江临床医学, 8, 340-341.
[13] 郭晓燕, 朱长连 (2010) 亚低温与EPO联合治疗新生儿窒息的安全性探讨. 中国妇幼保健, 25, 1936-1937.
[14] Sailhamer, E.A., Chen, Z., Ahuja, N., et al. (2007) Profound hypothermic cardiopulmonary bypass facilitates survival without a high complication rate in a swine model of complex vascular, splenic and colon injuries. Journal of the American College of Surgeons, 204, 642-653.
[15] Hsu, C.Y., Huang, C.H., Chang, W.T., et al. (2009) Cardioprotective effect of therapeutic hypothermia for postresuscitation myocardial dysfunction. Shock, 32, 210-216.