Using the molecular adsorbent recirculating system in the treatment of severe Tsutsugamushi disease complicated with multiple organ dysfunction syndrome.

Objective To evaluate the value of using the molecular adsorbent recirculating system(MARS) in the treatment of severe Tsutsugamushi disease complicated with multiple organ dysfunction syndrome(MODS).Methods Sixty patients diagnosed with severe Tsutsugamushi disease complicated with MODS were involved in this study.The patients were randomly divided into MARS cure group,continuous renal replace therapy(CRRT) cure group and the integrated routine cure group.Indexes on the flow dynamics,liver and renal function,coagulation function,respiration function,inflammatory mediators,and the Marshall values before and after therapy were compared between groups.The 60-day survival curves between the 3 groups were also compared.Results After MARS therapy,the Marshall values,mean heart rates,peak inspiratory airway pressure,serum total bilirubin,white cell counts and the plasma D-dimer levels were significantly decreased.The mean artery pressure,PaO2,oxygenation index,urine quantity and the platelet counts were significantly increased.The levels of NO,TNF-?琢,IL-6,IL-8 and LBP were significantly decreased.The levels of IL-10 and IL-13 were decreased concomitantly.These indexes in the MARS group were better than the routine integrated cure group and CRRT group(P0.05).After MARS therapy,the respiratory rate and the creatine level were significantly decreased.the levels of SaO2 and albumin were increased significantly,and these indexes in the MARS group were better than integrated routine cure group(P0.05).In the survival study,the survival rate was 90%(18/20) in the MARS group,45%(9/20) in the integrated routine cure group,and 60%(12/20) in the CRRT group.Conclusion MARS can be used in the treatment of severe Tsutsugamushi disease complicated with MODS.