低剂量甲泼尼龙治疗急性化脓性骨髓炎伴脓毒血症对T淋巴细胞亚群凋亡的影响  

Low dose of methylprednisolone in treatment of acute pyogenic osteomyelitis with sepsis:what's the effect on apoptosis of T lymphocyte subsets

作　　者：徐佳元[1] 杨卫良[1] 

机构地区：[1]哈尔滨医科大学附属第一医院骨科,黑龙江哈尔滨150001

出　　处：《中国矫形外科杂志》2016年第9期836-838,共3页Orthopedic Journal of China

基　　金：黑龙江省教育厅科学技术研究项目资助课题(项目编号:12541481)

摘　　要：[目的]探讨低剂量甲泼尼龙治疗急性化脓性骨髓炎伴脓毒血症对T细胞亚群凋亡的影响。[方法]选取2013年7月~2014年7月于本院就诊的急性化脓性骨髓炎伴脓毒血症患者共60例,将患者随机分为两组,观察组和对照组患者各30例,对照组患者给予常规治疗;观察组患者在对照组常规治疗的基础之上,进行低剂量甲泼尼龙治疗,比较两组患者的治疗效果。[结果]观察组和对照组治疗死亡率分别为16.7%、40%,观察组死亡率明显低于对照组。观察组在治疗48、72 h后CD4^＋T淋巴细胞和CD8^＋T淋巴细胞均明显高于对照组,CD4^＋/CD8^＋比值低于对照组。[结论]低剂量甲泼尼龙治疗急性化脓性骨髓炎伴脓毒血症有显著疗效,能调节T淋巴细胞的凋亡,改善患者的预后,降低死亡率。[Objective] To investigate the effect of low dose of methylprednisolone in treatment of acute pyogenic osteomyelitis with sepsis on apoptosis of T cell subsets. [Methods] Sixty patients suffering acute pyogenic osteomyelitis with sepsis received treatment in our hospital from July 2013 to July 2014. The patients were randomly divided into the observation group and the control group,with 30 cases in each. Patients in the control group received routine treatment,while in the observation group,patients were given low dose methylprednisolone besides the routine one. The treatment effects were compared between two gorups. [Results] The mortality rates in the observation group and the control group treatment were 16. 7%,40% respectively,indicating that the motality rate in the observation group was significantly lower than that of the control group（ P〈0. 05）. CD4^＋T lymphocytes and CD8^＋T lymphocytes in the observation group were significantly higher that those of the control group at 48 h,72 h after treatment,whereas the ratio of CD4^＋/ CD8^＋was lower than that of control group. [Conclusion]There is a significant effect of low dose of methylprednisolone in treatment of acute pyogenic osteomyelitis with sepsis,apoptosis can regulate T lymphocyte,improve the prognosis of patients,and reduce the mortality rate.

关 键 词：甲泼尼龙 急性化脓性骨髓炎 脓毒血症 T淋巴细胞亚群凋亡 

分 类 号：R681.2[医药卫生—骨科学]