重度脓毒症患者免疫增强治疗临床研究.docVIP

重度脓毒症患者免疫增强治疗临床研究 　　[摘要] 目的：分析重度脓毒症患者的细胞免疫状态，并研究α1胸腺肽对免疫调节治疗的影响。方法：选取2010年2月~2011年2月我院重度脓毒症患者135例，监测血清单核细胞人白细胞DR抗原（HLA-DR）、T淋巴细胞亚群绝对计数的动态变化；研究取CD4+T淋巴细胞绝对计数＜410 cells/μl的患者，并分为治疗组和对照组，治疗组再按CD4+T淋巴细胞绝对计数进行亚组分析。治疗组皮下注射α1胸腺肽1.6 mg/d，连续7 d，同时给予经典SSC治疗；对照组给予经典SSC治疗。观察患者治疗前及治疗后3、7 d上述免疫指标。结果：85例重度脓毒症患者HLA-DR、CD3+、CD4+和CD8+T淋巴细胞明显降低，治疗组治疗后7 d HLA-DR、CD3+、CD4+和CD8+均明显增高，且7 d HLA-DR、CD3+、和CD8+较3 d HLA-DR、CD3+和CD8+增高，差异有统计学意义（P 　　[关键词] 重度脓毒症；α1胸腺肽；细胞免疫；随机对照试验 　　[中图分类号] R631 [文献标识码] Ａ [文章编号] 1673-7210（2011）11（a）-054-04 　　 　　Clinical study of the immunopotentiation therapy in the patients with severe sepsis 　　ZHOU Qin, GUO Guangyun 　　Department of Respiratory, The People′s Hospital Affiliated to Hubei University of Medicine, Hubei Province, Shiyan 442000, China 　　[Abstract] Objective: To explore the cellular immunity state in the patients with severe sepsis and influences of immune-modulation therapy with Thymosin α1. Methods: 135 patients with severe sepsis in our hospital from February 2010 to February 2011 were enrolled. The trends of serum CD14+ monocyte HLA-DR levels, the absolute counting of T lymphocytes subpopulation were monitored. And the patients with severe sepsis were randomly divided into two groups by the absolute counting of CD4+T lymphocytes subpopulation＜410 cells/μl. The patients in control group were treated with classical SSC therapy, those in treatment group were treated with Thymosin α1, 1.6 mg subcutaneous injection per day, continued 7 days and classical SSC therapy. Levels of above immune indexes were detected before treatment and after 3 days and 7 days of treatment. Results: Levels of serum HLA-DR, CD3+, CD4+, CD8+ T lymphocyte were significantly decreased in 85 patients with severe sepsis. Levels of serum HLA-DR, CD3+, CD4+, CD8+ T lymphocyte were increased significantly after 7 days treatment in treatment group. These parameters were higher after 7 days than after 3 days (P 　　[Key words] Severe sepsis; Thymosin α1; Cellular im