Application effect of continuous blood purification combined with hemoperfusion in patients with severe sepsis complicated with acute respiratory distress syndrome and its influence on PCT, hs CRP and IL-6 levels

doi:10.3877/cma.j.issn.2095-9133.2026.01.006

Abstract

Abstract:

Objective

To explore the clinical application value of continuous blood purification (CBP) combined with hemoperfusion (HP) in patients with severe sepsis complicated with acute respiratory distress syndrome (ARDS).

Methods

The data of 160 patients with severe sepsis complicated with ARDS admitted to the Affiliated Hospital of Shanxi University of Traditional Chinese Medicine from August 2022 to August 2024 were retrospectively selected, including 93 males and 67 females. The age ranged from 41 to 82 years with an average of (63.22±3.58) years. Based on the differences in treatment methods, the patients were divided into two groups: a control group (80 cases) and an observation group (80 cases), who received different treatment plans including conventional treatment and CBP+HP; The hemodynamic indicators, inflammatory factor levels, biochemical indicators, blood gas indicators, prognostic outcomes, and the effects on inflammatory factors [procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6)] were compared between the two groups.

Results

After treatment, the heart rate of the two groups was lower than that of the control group (P<0.05), and the average arterial pressure of the two patient groups was higher than that of the control group (P<0.05); After treatment, both groups showed a decrease in IL-6, hs-CRP, and PCT, with the observation group showing a more significant decrease (P<0.05); After treatment, the arterial oxygen partial pressure (PaO₂) and oxygenation index (PaO₂/FiO₂) increased in both groups, especially in the observation group (P<0.05). After treatment, the levels of serum creatinine (SCr), lactate dehydrogenase (LDH) and serum lactic acid (LAC) in both groups showed a downward trend, and the decrease in the observation group was even greater (P<0.05). After treatment, the scores of acute physiology and chronic health status score system Ⅱ (APACHE Ⅱ) in both groups decreased, especially in the observation group (P<0.05).

Conclusion

The combined implementation of CBP and HP techniques in the treatment of severe sepsis complicated with ARDS not only regulates hemodynamics and reduces inflammatory factors, but also improves blood gas indicators and enhances patient prognosis.

Key words: Continuous blood purification, Blood perfusion, Sepsis, Acute respiratory distress syndrome, Inflammatory factors

Li Zhang, Qiaoni Li, Shuai He, Chaoxia Wang, Xiaokang Ning. Application effect of continuous blood purification combined with hemoperfusion in patients with severe sepsis complicated with acute respiratory distress syndrome and its influence on PCT, hs CRP and IL-6 levels[J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2026, 12(01): 26-31.

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组别	例数	心率（次/min）		平均动脉压（mmHg）
组别	例数	治疗前	治疗后	治疗前	治疗后
对照组	80	121.41±6.06	92.54±5.88^a	65.26±8.15	72.33±7.54
观察组	80	121.22±6.87	86.22±5.35^a	64.87±7.92	76.53±6.88
t值		0.19	7.11	0.31	3.68
P值		>0.05	<0.001	>0.05	<0.001

组别	例数	心率（次/min）		平均动脉压（mmHg）
组别	例数	治疗前	治疗后	治疗前	治疗后
对照组	80	121.41±6.06	92.54±5.88^a	65.26±8.15	72.33±7.54
观察组	80	121.22±6.87	86.22±5.35^a	64.87±7.92	76.53±6.88
t值		0.19	7.11	0.31	3.68
P值		>0.05	<0.001	>0.05	<0.001

组别	例数	IL-6（mg/L）		Hs-CRP（mg/L）		PCT（ng/mL）
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	80	55.63±4.25	47.24±4.25^a	9.87±1.63	5.22±1.26^a	13.43±3.63	7.54±2.03^a
观察组	80	55.22±4.36	42.29±2.87^a	9.82±1.57	3.02±0.96^a	13.33±3.82	4.34±1.07^a
t值		0.60	8.63*	0.20	12.42*	0.17	12.47*
P值		>0.05	<0.001	>0.05	<0.001	>0.05	<0.001

组别	例数	IL-6（mg/L）		Hs-CRP（mg/L）		PCT（ng/mL）
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	80	55.63±4.25	47.24±4.25^a	9.87±1.63	5.22±1.26^a	13.43±3.63	7.54±2.03^a
观察组	80	55.22±4.36	42.29±2.87^a	9.82±1.57	3.02±0.96^a	13.33±3.82	4.34±1.07^a
t值		0.60	8.63*	0.20	12.42*	0.17	12.47*
P值		>0.05	<0.001	>0.05	<0.001	>0.05	<0.001

组别	例数	PaO₂（mmHg）		PaO₂/FiO₂
组别	例数	治疗前	治疗后	治疗前	治疗后
对照组	80	67.52±5.88	78.25±8.25^a	150.22±11.85	196.36±12.33^a
观察组	80	67.22±7.23	83.33±8.23^a	149.63±12.33	220.54±13.58^a
t值		0.29	3.90	0.31	11.79
P值		>0.05	<0.001	>0.05	<0.001

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