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目的:探讨连续性肾脏替代治疗(CRRT)老年重症肺炎合并全身炎症反应综合征患者的效果评价。方法:本研究为随机对照研究，选取2013年1月至2024年1月在北部战区总医院干部病房及重症医学科收治的90例老年重症肺炎合并全身炎症反应综合征患者，男62例，女28例，年龄(68±7)岁，年龄范围为61～75岁，采用随机数表法将患者随机分为常规治疗组与CRRT组，每组45例。常规治疗组采用常规治疗，CRRT组在常规治疗组的基础上加用CRRT，比较两组患者呼吸频率恢复正常时间、体温正常时间、住院时间、炎症因子水平[白细胞介素-6、C反应蛋白(CRP)、降钙素原]、有效率及并发症发生率。结果:CRRT组患者呼吸频率恢复正常时间[(10.62±2.92)h]、体温正常时间[(20.09±6.35)h]及住院时间[(7.12±2.02)d]均短于常规治疗组[(19.58±5.44)h、(47.59±13.42)h、(12.85±5.59)d]。治疗3 d后，CRRT组患者的白细胞介素-6[(11.94±2.46)ng/L]、CRP[(0.84±0.58)ng/L]及降钙素原[(188.27±28.02)ng/L]水平均低于常规治疗组[(15.39±3.15)ng/L、(1.42±0.17)ng/L、(249.95±35.72)ng/L]；CRRT组患者有效率[86.7%(39/45)]高于常规治疗组[66.7%(30/45)]；CRRT组患者并发症发生率[4.4%(2/45)]低于常规治疗组[28.9%(13/45)]，差异有统计学意义( P<0.05)。 结论:CRRT老年重症肺炎合并全身炎症反应综合征，患者呼吸窘迫消失时间和住院时间较短，炎症因子水平较低，治疗效果较好，且并发症发生率较低。

Objective:To explore the efficacy evaluation of continuous renal replacement therapy(CRRT) in elderly patients with severe pneumonia complicated with systemic inflammatory response syndrome.Methods:This study was a randomized controlled study, a total of 90 elderly patients with severe pneumonia complicated with systemic inflammatory response syndrome admitted to the department of Cadre Wards and Critical Care Medicine in General Hospital of Northern Theater Command from January 2013 to January 2024.There were 61 males and 29 females, aged(68 ± 7) years old, ranging from 61 to 75 years old.The patients were randomly divided into conventional treatment group and CRRT group using a random number table method, with 45 cases in each group.The conventional treatment group received conventional treatment, while the CRRT group received CRRT in addition to the conventional treatment group.Time for respiratory rate to return to normal, time for body temperature to return to normal, length of hospital stay, levels of inflammatory factors[interleukin-6, C-reactive protein(CRP), procalcitonin], effective rate, and incidence of complications were compared between the two groups of patients.Results:The time for respiratory rate to return to normal[(10.62 ± 2.92) h], body temperature to normal[(20.09 ± 6.35) h], and hospital stay[(7.12 ± 2.02) d]in CRRT group were all shorter than those in conventional treatment group[(19.58 ± 5.44) h, (47.59 ± 13.42) h, (12.85 ± 5.59) d].After 3 d of treatment, the levels of interleukin-6[(11.94 ± 2.46) ng/L], CRP[(0.84 ± 0.58) ng/L], procalcitonin[(188.27 ± 28.02) ng/L]in CRRT group were lower than those in conventional treatment group[(15.39 ± 3.15) ng/L, (1.42 ± 0.17) ng/L, (249.95 ± 35.72) ng/L]; the effective rate of patients in CRRT group[86.7%(39/45)]was higher than that in conventional treatment group[66.7%(30/45)]; the incidence of complications in CRRT group[4.4%(2/45)]was lower than that in conventional treatment group[28.9%(13/45)], and the differences were statistically significant( P<0.05). Conclusions:Severe pneumonia in elderly patients with CRRT combined with systemic inflammatory response syndrome has a shorter disappearance time of respiratory distress and hospital stay, lower levels of inflammatory factors, better treatment effect, and lower incidence of complications.