连续血液滤过对严重脓毒症患者免疫抑制状态的影响.pdfVIP

866 TI叫in Med J, Dec 2∞6， Vol 34 No 12 连续血液滤过对严重版毒症患者免疫抑制状态的影响 王兵张畔曹书华 摘要E 目的:探讨连续性静静脉血液滤过(continuous venovenous hemofiltration ， CVVH)对严重除毒症患者血流动 力学和外周血辅助性T 细胞亚群咽ltrh2 平衡的影响。方法:前瞻性观察应用 CVVH 治疗 18 例严重隙毒症患者，于 CVVH 治疗前和治疗后4、 8h 抽取静脉血应用流式细胞仪检测外周血辅助性T 细胞亚群Thl 1Th2 比值变化，同时观察 生化指标、血流动力学变化。结果:18 例患者CVVH 治疗眉血清BVN、 Scr 较治疗前均景下降趋势(P O.OI) ， MAP 跟辛苦 上升(P 0.01)，而多也腊、去lfI肾上腺素用最显著降低(PO.Ol) ， Thl厅h2 比值3呈上升趋势，差异具有统计学意义(P 0.05 或P 0.01) 。结论:CVVH 能改静严道隙毒症患者血流动力学及免疫麻痹状态。 关键词血液捕过服毒症免搜耐受血液动力学过程 T 淋巴细胞亚群 Effects of Continuous Hemofiltration on Immunosuppression in Severe Sepsis WANGBi吨， ZHANG Pan , CAO Shuhua Dep耐附ntoflC以 First Centre Hospital ofTianjin, Tianjin 300192, China Abstract Objective: To study the effects of continuous venovenous hemofiltration (CVVH) on the hemodynamics and the balance of Th l-Th2 in severe sepsis. Methods: 在ighteen severe septic patients were treated with CVVH. 切11月h2 of peripheral T helper T cell were measured before and 4 皿d 8h after CVVH treatment. Blood biochemical indexes and hemodynamics parameters were observed. Resul始: BVN and Scr decreased si伊ificanùy (P 0.01), MAP increased significanÙy (P 0.01),the dose of dopamine and norepinephrine decreased significanÙy (P 0.01) , and Thl月h2 increωed after CVVH treatment in 18 patients.η1e d晶rences were significant (P 0.05 or P 0.01). Conclusion: CVVH can improve the hemodynamics and the ímmunosuppreSSlOn in severe septíc. Key words hemofiltration sepsis immune tolerance hemodynamic processes T-lymphocyte subsets 1.2 CVVH 方法 瞅毒症是创伤、烧伤、休克和感染等危重病患 1.2.1 血管通路和血撞器患者均果用Seldinger 技术行股 者的严重并发症之一，也是诱发多脏