脓毒症患者连续性血液净化治疗后免疫功能动态变化规律探讨  

The Impact of Continuous Blood Purification Treatment within 24 Hours on Immune Function in Patients with Sepsis

作　　者：韦明恒[1] 周红卫[2] 史应龙[1] 

机构地区：[1]广西医科大学,广西南宁530021 [2]广西医科大学第一附属医院

出　　处：《中外医学研究》2012年第14期1-3,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨首次连续性血液净化(CBP)治疗24h对脓毒症患者免疫功能的影响,掌握其免疫功能动态变化规律。方法:20例符合脓毒症诊断标准患者被随机分成CBP组和对照组,各10例,CBP组行CBP+常规治疗,对照组仅行常规治疗,测定不同时段中性粒细胞吞噬率、吞噬指数、CD4+/CD8+比值、C反应蛋白(CRP)、肾功能、电解质及血乳酸。结果:连续性血液净化治疗组中性粒细胞吞噬率、吞噬指数、CD4+/CD8+比值8h后开始升高,16h达到高峰,24h略有回落,但均较治疗前升高,差异有统计学意义(P<0.05);而C反应蛋白(CRP)8h后开始下降,16h达到谷值,24h略有回升,但均较治疗前低,差异有统计学意义(P<0.05)。结论:连续性血液净化治疗24h可帮助患者重建免疫功能稳态。Objective：To investigate the impact of continuous blood purification treatment within 24 hours on immune function in patients with sepsis.Methods：20 sepsis patients were divided into CBP group and control group.ten patients in CBP group underwent CBP and conventional treatment and the other ten patients in control group underwent conventional treatment only.Neutrophil phagocytosis rate,phagocytic index,CD4＋/CD8＋ ratio,C-reactive protein（CRP）,renal function,electrolyte of both group were measured.Results：Neutrophil phagocytosis rate,phagocytic index,and CD4＋/CD8＋ ratio were significantly elevated at each point time after CBP compared with those before CBP（P0.05）.All the above index got increased after 8 hours of treatment and reached the peak at 16 h and decreased slightly in 24 h.C-reactive protein（CRP） was decreased at each point time after CBP compared with that before CBP（P0.05）.Conclusion：CBP can improve the immune function of patients with sepsis,which get improved 8 h after CBP and reach peak at 16 h after CBP.

关 键 词：连续性血液净化 脓毒症 中性粒细胞吞噬功能 CD4+/CD8+ C反应蛋白 

分 类 号：R459.7[医药卫生—急诊医学]