Objective To investigate the efficacy of continuous renal replacement therapy(CRRT)versus intermittent hemodialysis(IHD)in patients with severe acute renal failure(ARF).Methods One hundred and ninety -three severe ARF...
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Objective To investigate the efficacy of continuous renal replacement therapy(CRRT)versus intermittent hemodialysis(IHD)in patients with severe acute renal failure(ARF).Methods One hundred and ninety -three severe ARF patients who received renal support between December 1978 and December 1998 were involved in this *** them,101(52.3%)were treated with CRRT(CRRT group),and 92(47.7%)with IHD(IHD group).Results Sixty(59.4%)patients in the CRRT group got through the acute phase of disease and 41 (40.6%)patients did not survive while in the IHD group 59(64.1%)patients survived and 33(35.9%)patients did *** significant difference in survival rate was found between the two groups.24 of 64 patients(37.5%)in the CRRT group with multiple organ dysfunction syndrome(MODS)survived,while in the IHD group,8 out of 44(27.3%)survived,their survival rate was much lower than that in the CRRT *** in CRRT group were more severely iii,as manifested by lower mean arterial pressure,higher APACHE Ⅱ score,more dysfunctioned organs and requiring mechanical ventilation and vasopressor support as compared with patients in the IHD group,CRRT was found to improve hemodynamic stability with a better fluid balance and control of biochemical status,increased nutritional intake and a shorter duration of acute renal failure(P ＜ 0.05).Conclusion CRRT perhaps may be the best choice in the treatment of severe ARF patients,for it can offer several distinct advantages compared to *** may contribute to improving the survival rate of ARF patients,particularly those that are critically ill patients.
经典的主要组织相容性复合体(MHC)在排斥反应的发生、发展方面具有重要作用,但越来越多的研究表明某些非经典MHC基因在此过程中,乃至在其他疾病的免疫机制方面同样意义显著。主要组织相容性复合体Ⅰ类分子链相关基因A(major histocompatibility complex class I related chain A,MICA)即属于非经典MHC-I类基因。大量研究表明,作为最具多态性的非经典MHC-I类基因,其表达产物可借助NKG2D与自然杀伤细胞、某些特定T细胞亚群等多种免疫细胞相互作用,从而在病毒感染的免疫监视、自身免疫性疾病与器官移植排斥反应的发生发展方面均具有重要意义。
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