| Purpose:We sought to study preliminarily the function of CVVH on eliminating cytokines in peripheral blood of patients with SIRS, and the role in improving endothelial function and clinical outcome.Patients and Methods:19 cases of SIRS with the therapy of CVVH in hemodialysis center of Shandong Provincial Hospital were chosen, and their plasma were collected before and after CVVH every 24h. Enzyme linked immunosorbent assay was used for determining the concentration of tumor necrosis factor-a, interleukin-6, interleukin-10, thrombomodulin and E-selection. APACHII score before and after treatment was used to evaluate its clinical efficacy.Results:Clinical outcome:Compared with pre-treatment, APACHE II scores improved significantly(P<0.01) after CVVH in 19 patients.Cytokine levels:The concentration of IL-6, TNF-a and IL-10 after CVVH of 24 hours were significantly reduced (P<0.05) comparing with pre-treatment in 19 patients, and there was a downward trend on the concentration of these cytokines in the next consecutive therapy of CVVH..Markers of endothelial cell level:The concentration thrombomodulin and sE-selection after CVVH of 24 hours were not significantly reduced comparing with pre-treatment (P>0.05). After all the CVVH treatment for several days, the concentration of thrombomodulin and sE-selection had a download trend, but the difference were not statistically significant (P>0.05).Conclusions:CVVH can improve the prognosis of patients with SIRS, reducing the mortality rate. CVVH also can effectively remove cytokines, reducing inflammation and improving the state of organ failure. CVVH can not effectively reduce the concentration of markers indicating endothelial dysfunction in vivo, however, the further injury of endothelial function may be prevented by removing cytokines and homeostasis, thereby improving prognosis. Meanwhile, it may be useful to choose the right time of CVVH for improving endothelial function.
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