连续性血液滤过对脓毒症休克患者炎性指标及细胞免疫功能影响.docVIP

连续性血液滤过对脓毒症休克患者炎性指标及细胞免疫功能影响 　　【摘要】 目的：探讨脓毒症休克患者早期应用血液净化治疗，对其炎性指标及细胞免疫功能的影响。方法：将130例确诊脓毒症休克患者随机分为血滤组与常规组，每组各65例。血滤组在综合治疗基础上给予连续性肾脏替代治疗（CRRT），持续治疗72 h。监测两组患者入院时及第3、7天血清C反应蛋白水平，淋巴细胞亚群CD3+、CD4+、CD8+、CD4+/CD8+水平，治疗前后急性生理学与慢性健康状况（APACHEⅡ）评分。结果：两组患者治疗后C反应蛋白均较治疗前降低，治疗后血滤组各时点数据低于常规组，两组比较差异有统计学意义（P0.01）。治疗后两组患者外周血T淋巴细胞亚群水平（CD3+、CD4+、CD4+/CD8+）均较治疗前明显升高，比较差异均有统计学意义（P0.05）；治疗后血滤组各时点数据较常规组患者升高更明显，比较差异均有统计学意义（P0.01）。两组患者治疗后APACHEⅡ评分均较治疗前降低，治疗后血滤组数据低于常规组，比较差异均有统计学意义（P0.01）。结论：脓毒症休克患者早期应用连续性血液净化治疗，可以显著抑制全身炎症反应，改善患者的细胞免疫功能，提高患者疗效。 　　【关键词】 血液滤过； 脓毒症休克； 细胞免疫 　　【Abstract】 Objective：To investigate the effects of early application of blood purification treatment on the immune function of patients with sepsis.Method：The 130 patients diagnosed with sepsis were randomly divided into the blood filter group and the conventional group，65 cases in each group.The blood filtration group was treated with CRRT on the basis of comprehensive treatment，continuous treatment was 72 h.The levels serum C-reactive protein on admission，3 days，and 7 days of two groups were monitored，the lymphocyte subsets CD3+，CD4+，CD8+，CD4+/CD8+ levels，before and after treatment of acute physiology and chronic health conditions （APACHEⅡ） score of two groups were compared.Result：After treatment，the levels of C-reactive protein was lower than before treatment，the time points of the blood filter group were lower than those in the conventional group，the differences were statistically significant（P0.01）.After treatment， the peripheral blood T lymphocyte subgroup levels （CD3+，CD4+，CD4+/CD8+） of two groups were obviously higher than before treatment， the blood filter group each point experimental data was higher than the conventional group，the differences were statistically significant（P0.05）.After treatment，the APACHEⅡ scores were lower than those in the treatment group，the experimental data of the blood filter group were lower than those in the conventional group，the differences were statistically significant（P0.01）.Conclus