连续血液净化治疗严重脓毒症的疗效及免疫调节机制分析  

Analysis of efficacy and immune regulation mechanism of continuous blood purification in treatment of severe sepsis

作　　者：占成业[1] 万磊[1] 罗金龙[1] 陈娣[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院急诊科ICU,武汉430030

出　　处：《临床急诊杂志》2016年第7期546-549,共4页Journal of Clinical Emergency

摘　　要：目的:探讨连续血液净化(continous blood purification,CBP)治疗严重脓毒症患者的疗效及免疫调节机制分析。方法:选取我院ICU收治的严重脓毒症患者100例,随机分两组,其中采用常规疗法为对照组(50例),在对照组的基础上采用CVVH疗法为观察组(50例),比较两组患者治疗前后的各项生命体征、APACHEⅡ评分、T细胞亚群的水平及并发症发生率。结果:观察组患者血流动力学指标、氧合指数、APACHEⅡ评分、血肌酐、多器官功能衰竭发生率、ICU住院时间、机械通气时间、死亡率与对照组比较差异均有统计学意义(P<0.05)。两组在CBP治疗后,CD4+,CD3+的水平及CD4+/CD8+比值均较治疗前升高(P<0.05),而CD8+差异无统计学意义。结论:利用连续性血液净化治疗严重脓毒症,可有效除去患者毒素和致炎介质,维持内稳态,改善氧合功能,并且提高治疗的成功率。Objective：To study efficacy of continuous blood purification（CBP）on patients with severe sepsis and analysis of immune regulation mechanism.Method：One hundred patients with severe sepsis from our ICU were randomly divided into two groups,i.e.control group（conventional treatment group,n=50）and observation group（CVVH group,n=50）.Vital signs,APACHEⅡscores,levels of T-cell subsets,and complication rates between two groups were compared.Result：The hemodynamic parameters,oxygenation indexes,APACHEⅡscores,serum creatinine,the incidence of multiple organ failure,ICU length of stay,duration of mechanical ventilation,and mortality in observation group showed significant difference（P〈0.05）compared with control group After CBP therapy.The levels of CD4＋,CD3＋,and the CD4＋/CD8＋ratio were all increased（P〈0.05）.However,there was no significant difference in CD8＋.Conclusion：Treatment of severe sepsis by using continuous blood purification can effectively remove toxins and inflammatory mediators,maintain homeostasis,improve oxygenation thus improving the cure rates of severe sepsis.

关 键 词：连续血液净化 免疫调节 严重脓毒症 

分 类 号：R459.5[医药卫生—治疗学]