Objective To investigate the clinical efficacy of sustained low-efficiency daily diafiltration( SLEDD-f) combined with hemoperfusion( HP)in treatment of sepsis-induced acute kidney injury. Methods A total of 43 patients with sepsis-induced acute kidney injury who received CRRT or SLEDD-f combined with HP treatment in department of emergency, the First Hospital Affiliated to Nanhua University from January 2008 to December 2011,were divided into CRRT group( C group,21 cases)and LEDD-f combined with HP treatment group( T group,22 cases)according to various blood purification methods. APCHEⅡ score,mean arterial pressure( MAP),dopamine( DA)dose,levels of serum creatinine( Scr),hemo-globin(Hb),Albumin(Alb),white blood cell count(WBC),high-sensitivity C-reactive protein(hs-CRP),serum IL-6,IL-10 and tumor necrosis factor-α(TNF-α)before and after treatment were compared between two groups. The com-plication rates,30 days survival rates,and the duration of ICU stays were compared between two groups. Results There was no statistical difference in APCHEⅡ score,MAP,DA dose,levels of Scr,Hb,Alb,WBC,hs-CRP,IL-6,IL-10 and TNF-α before treatment between two groups(P .0. 05). There were significant differences in MAP,DA dose,levels of Scr, WBC,hs-CRP,IL-6,IL-10 and TNF-α after treatment between two groups(P<0. 05). Patients in two groups had no serious complications during therapy period. The 30 days survival rate in group C〔47. 6%(10/21)〕was significantly lower than that〔77. 3%(17/22)〕in group T(χ2 =4. 044,P<0. 05). The duration of ICU stays in group C〔(16. 3 ± 5. 2) d〕was significantly longer than that in group T〔(11. 2 ± 3. 5)d〕(t=3. 789,P<0. 05). Conclusion The clinical efficacy of SLEDD-f combined with HP is better than CRRT in the treatment of sepsis-induced acute kidney injury,and 30 days survival rate is higher,duration of ICU stays is shorter,SLEDD-f combined with HP therapy is a new treatment program for patients with sepsis-induced acute kidney injury.%目的：观察连续低效每日血液透析滤过（ SLEDD-f）联合血液灌流（ HP）治疗脓毒症急性肾损伤（ AKI）的临床疗效。方法选取2008年1月-2011年12月南华大学附属第一医院急诊ICU行连续性肾脏替代治疗（ CRRT）或SLEDD-f联合HP治疗的脓毒症AKI患者43例，根据血液净化方式不同分为CRRT组（ C组，21例）和SLEDD-f联合HP治疗组（ T组，22例），比较两组患者治疗前及治疗后急性生理学及慢性健康状况评分系统Ⅱ（APACHEⅡ评分）、平均动脉压（MAP）、多巴胺（DA）用量、血清肌酐（Scr）、血红蛋白（Hb）、清蛋白（Alb）、白细胞计数（ WBC）、超敏C反应蛋白（ hs-CRP）、白介素（ IL）-6、IL-10、肿瘤坏死因子α（ TNF-α）水平变化，比较两组患者并发症情况及30 d存活率、ICU停留时间。结果治疗前两组患者APACHEⅡ评分、MAP、DA用量及Scr、Hb、Alb、WBC、hs-CRP、IL-6、IL-10、TNF-α水平比较，差异均无统计学意义（ P .0.05）。治疗后两组患者MAP、DA用量及Scr、WBC、hs-CRP、IL-6、IL-10、TNF-α水平比较，差异均有统计学意义（ P<0.05）。两组患者治疗期间均无严重并发症。C组患者30 d存活率为47.6%（10/21）低于T组的77.3%（17/22）（χ2=4.044，P<0.05）。C组患者ICU停留时间（16.3±5.2）d长于T组的（11.2±3.5）d（t=3.789，P<0.05）。结论SLEDD-f联合HP治疗脓毒症AKI的疗效较CRRT更好，30 d存活率升高，ICU停留时间缩短，为脓毒症AKI患者提供新的治疗方案。
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