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    Effects of sustained low-efficiency diardtration on intestinal mucosal barrier dysfunction and immune dysfunction in patients with severe acute pancreatitis

    Deng Yanyan;Jin Sha;Ye Tingting;Shen Jianming;Li Junfeng;Xiao Shouhai;Department of Nephrology,Renmin Hospital,Hubei Univerity of Medicine;  
    Objective To evaluate the effect of sustained low-efficiency diafiltration(SLEDF) on intestinal mucosal barrier dysfunction and immune dysfunction in patients with severe acute pancreatitis(SAP).Methods Fifty-one patients with SAP were randomly divided into continuous veno-venous hemofiltration(CVVH) group with 25 patients and SLEDF group with 26 patients,CVVH and SLEDF were treated separately on the basis of routine treatment.Prognosis,recovery time for blood and urine amylase,blood D-lactic acid,endotoxin(ET),diamine oxidase(DAO),CD3~+,CD4~+,CD8~+T lymphocyte levels,CD4~+/CD8~+T lymphocyte ratio before and on the 2 nd,4 th,8 th,14 th day after treatment,complications related to blood purification were collected and compared in the two groups.Results There were no significant differences between the two groups in the mortality rate and the recovery time of blood and urine amylase,there were no significant differences in blood D-lactic acid,ET,DAO,CD3~+,CD4~+,CD8~+T lymphocyte levels,CD4~+/CD8~+T lymphocyte ratio between the two groups before and on the 2 nd,4 th,8 th,14 th day after treatment(P 0.05).The levels of D-lactic acid,ET and DAO in both groups were lower on the 2 nd,4 th,8 th,14 th day after treatment,the levels on the 8 th and 14 th day were lower than those on the 4 th day(P 0.05).CD3~+,CD4~+T lymphocyte levels,CD4~+/CD8~+T lymphocyte ratio in the two groups on the 4 th,8 th,14 th day were higher than those in the same group before treatment,the levels on the 8 th and 14 th day were higher than those on the 4 th day(P 0.05).CD8~+T lymphocyte levelin the two groups on the 4 th,8 th day were lower than those in the same group before treatment,the levels on the 8 th and 14 th day were lower than those on the 4 th day(P 0.05).Conclusion SLEDF and CVVH could improve intestinal mucosal barrier dysfunction and immune dysfunction in SAP patients.SLEDF is worth popularizing in clinic because of convenient operation and low medical cost.
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