【摘要】 目的 观察连续性血液透析滤过(CVVHDF)对多器官功能障碍(MODS)犬脂多糖(LPS)、脂多糖结合蛋白(CD14)、高迁移率族蛋白-1(HMGB-1)、转化生长因子-β（TGF-β）的影响，并探讨CVVHDF治疗MODS的作用机制。方法 经失血性休克+复苏灌注+内毒素血症建立犬MODS模型，随机分为MODS组和CVVHDF组。内毒素注射完毕后CVVHDF组接受CVVHDF治疗24 h；MODS组未接受CVVHDF治疗。测定各时间点血浆及超滤液LPS、CD14、HMGB-1、-TGF-β浓度。结果 CVVHDF治疗后，LPS、CD14和 HMGB-1浓度水平下降，均在T6、T7、T8及T9时间点显著低于MODS组(P<0．05),差异有统计学意义；TGF-β浓度水平缓慢升高，在T5、T6、T7、T8及T9时间点显著高于MODS组(P<0．01) 差异有统计学意义。在超滤液中能检测出CD14、HMGB-1和TGF-β，SC分别为0．78±0．10、0．7.±0．09、0．82±0．09；未能检测出LPS。CVVHDF治疗后明显减轻了心脏和肝脏的组织组损害。结论 CVVHDF能清除MODS相关炎症介质和抗炎介质，重建机体免疫系统内稳状态，阻止脏器进一步损害，起到防治MODS的作用。

【Abstract】Objective To investigate the effects of continuous venovenous haemodiafltration (CVVHDF) on levels of LPS、CD14、HMGB-1 and TGF-β in multiple organ dysfunction syndrome (MODS )dogs, and explore the treatment mechanism of CVVHDF. Methods Dogs were subjected to hemorrhasie shock plus resuscitation and endotoxemia to set up MODS model, then they were randomly divided into 2 groups：MODS group (n = 6) and CVVHDF group (n = 6). After endotoxin injection complete ，the CVVHDF group received CVVHDF treatment for 24 h; MODS group did not receive CVVHDF treatment. The concentrations of LPS、CD14、HMGB-1 and TGF-β in plasma and ultrafiltrate were measured with different time points. Results P了asma levels of LPS、CD14 and HMGB-1 were signmcantly decreased in the CVVHDF group at T6、T7、T8 and T9 after endotoxin injection as compared with MODS group (P<0．05). TGF-β levels were increased in the CVVHDF group at T5、T6、T7、T8 and T9 after endotoxin injection as compared with MODS group (P<0．01). The sieving coeffcients (SC) for CD14、HMGB-1 and TGF-β were 0．78±0．10、0．7.±0．09 and 0．82±0．09.LPS could not be detected in the ultrafiltrate. CVVHDF treatment were significantly reduced the heart and the liver tissue damage. Conclusion CVVHDF could effectively reduce the levels of pro-inflammatory mediator and anti-inflammatory cytokine related to MODS, rebuild the immune steady-state and protect or gans injured further in the prevention and treatment of MODS.