危重症患者血催乳素、免疫功能与预后关系.docVIP

危重症患者血催乳素、免疫功能与预后关系 　　【摘要】目的 本研究探讨危重症患者血清催乳素（prolactin，PRL）水平、免疫功能改变及预后的关系。方法 选择福建省立医院内科重症监护室2010年10月1日至2011年10月1日收治的符合标准资料完整的80例危重症患者，根据预后分为死亡组与存活组。分别于入院第2天、第4天、第8天早晨抽取空腹血，用化学发光免疫分析系统检测其外周血血清PRL，流式细胞仪检测其外周血中T淋巴细胞亚群，免疫速率散射比浊法检测其外周血中体液免疫五项，并用多因素重复测量方差分析对两组进行比较分析。结果 和存活组比较，死亡组危重症患者血清PRL值（P为0.037，0.036，0.030）和外周血CD3﹢（P为0.034，0.023，0.023）、CD4﹢（P为0.046，0.003，0.046）、CD8﹢（P为0.040 1，0.039，0.045）细胞百分数明显低于存活组。血清PRL值和CD3﹢、CD4﹢、CD8﹢正相关（P为0.004，0.043，0.003），血清PRL值越高，CD3﹢、CD4﹢、CD8﹢细胞百分数越高。结论 细胞免疫的改变，对患者的预后有重要影响，细胞免疫下降，提示预后不良。血清PRL对细胞免疫功能可能有着正调节作用。 　　【关键词】催乳素；细胞免疫；体液免疫；危重症；预后；内分泌系统；免疫调节；急性生理学与慢性健康状况评分系统 　　The relationship between the serum prolactin， immunity and prognosis of the critical patients SHI Song-jing， YOU Ting-ting. Department of Medical Intensie Care Unit， Fujian Provincial Hospital， Fujian Medical University， 350001 Fuzhou， China 　　Corresponding author：SHI Song-jing， Email： serena10@ 　　【Abstract】Objective To clarify the relationship between the serum prolactin （PRL）， immunity and prognosis of the critical patients.Methods The data of 80 patients with complete clinical data in the Intensive Care Unit of the Fujian Provincial Hospital during October 1， 2010 to October 1， 2011 were collected. The patients were divided into 2 groups according to the prognosis： death group and survival group. Fasting blood is extracted respectively on the morning of the 2nd day after they were admitted， the 4th day and the 8th day. Chemiluminescence immunoassay system was used to detect the serum PRL， flow cytometers to test peripheral blood T-lymphocyte subsets， and immunization rate nephelometry to check the 5 items for humoral immunity in peripheral blood. The multi-factor repeated measure analysis of variance was used in the comparison of the two groups. Results Compared with those of the survival group， the serum PRL（P=0.037，0.036，0.030）， the percentages of CD3﹢（P=0.034，0.023，0.023）， CD4﹢（P=0.046，0.003，0.046）and CD8﹢（P=0.040，0.039，0.045）cells of the death group were significantl