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目的：研究连续性肾脏替代治疗（ＣＲＲＴ）过程中外周血中肿瘤坏死因子（ＴＮＦ）、白细胞介素８（ＩＬ８）和内皮衍生血管舒张因子一氧化氮（ＮＯ）浓度的变化。方法：５例重症急性肾功能衰竭（肾衰）患者在明确诊断之后即开始行ＣＲＲＴ，每天持续１０～１２小时。血管通路采用动静脉内瘘或颈内静脉留置导管，ＡＫ１０血泵建立体外循环，血滤器采用ＦＨ６６Ｄ型（聚酰胺膜，０．６ｍ２）。治疗前和治疗１、２、３、６、９和１２小时（或结束时）取血和超滤液检测ＴＮＦ、ＩＬ８和ＮＯ的浓度。结果：５例患者均存活且肾功能恢复正常。ＣＲＲＴ开始１小时后外周血中ＴＮＦ浓度轻度升高，但在治疗过程中缓慢降低，６小时达到最低水平，与治疗前相比差异十分显著〔（１０８０±５３５）ｎｇ／Ｌ比（１６８０±７８３）ｎｇ／Ｌ，Ｐ＜０．０１〕，随后直到１２小时，其浓度基本稳定无显著变化；ＩＬ８浓度也在６小时降至最低值，但与治疗前比较无统计学差异〔（３９４±１２１）ｎｇ／Ｌ比（４６８±１４８）ｎｇ／Ｌ，Ｐ＞０．０５〕。ＮＯ水平在ＣＲＲＴ开始后亦缓慢降低，９小时达到最低值，但与治疗前相比差异不显著〔（９６±４８）μｍｏｌ／Ｌ比（１０６±４３）μｍｏｌ／Ｌ，Ｐ＞０．０５〕；超?
Objective: To investigate the changes of tumor necrosis factor (TNF), interleukin 8 (IL 8) and endothelium-derived vasodilator nitric oxide (NO) in patients with continuous renal replacement therapy (CRRT). METHODS: Five patients with severe acute renal failure (renal failure) started CRRT after a definite diagnosis and continued for 10 to 12 hours daily. Vascular access arteriovenous fistula or jugular vein indwelling catheter, AK10 blood pump to establish cardiopulmonary bypass, blood filter FH66D type (polyamide membrane, 0.6m2). Before treatment and at 1, 2, 3, 6, 9 and 12 hours (or at the end of treatment), blood and ultrafiltrate were taken to measure the concentrations of TNF, IL8 and NO. Results: All 5 patients survived and their renal function returned to normal. The level of TNF in peripheral blood slightly increased one hour after the start of CRRT, but decreased slowly during the course of treatment and reached the lowest level at 6 hours, which was significantly different from that before treatment [(1080 ± 535) ng / L vs (1680 ± 783) ng / L, P <0.01], and then remained stable until 12 hours later. The concentration of IL8 also dropped to the lowest level at 6 hours, but there was no significant difference compared with that before treatment [(394 ± 121) ng / L ratio (468 ± 148) ng / L, P> 0.05〕. The level of NO decreased slowly after the onset of CRRT, reached the lowest level at 9 hours, but not significantly different from that before treatment (96 ± 48 μmol / L, 106 ± 43 μmol / L, P> 0.05) ;ultra?