PICCO监测指导下液体复苏对脓毒性休克患者炎症因子和免疫功能的影响  

Effect of fluid resuscitation guided by PICCO detection on inflammatory factors and immune function in patients with septic shock

作　　者：黄艳[1] 彭禺雄 徐彬强 石凤姣[1] Huang Yan;Peng Yuxiong;Xu Binqiang;Shi Fengjiao(Department of Emergency,The fourth hospital of Changsha,Changsha,China)

机构地区：[1]长沙市第四医院急诊科

出　　处：《实用休克杂志（中英文）》2019年第5期282-284,共3页Journal of Practical Shock

摘　　要：目的探索PICCO监测指导下液体复苏对脓毒性休克患者炎症因子和免疫功能的影响。方法选取2018年2月结束于2019年2月,入住长沙市第四医院的脓毒性休克患者92例,随机分为研究组(n=46)与对照组(n=46)。对照组行常规液体复苏,研究组在PICCO监测指导下液体复苏。比较两组患病情变化,检测外周血CD4+CD25+TREG、miR-155、IL-10、ET-1表达以及复苏前后ET、vWF水平。结果研究组复苏液体量低于对照组(P<0.05),但两组患者乳酸、肌酐无差异(P>0.05)。研究组外周血CD4+CD25+TREG细胞、miR-155表达高于对照组(P<0.05)。IL-10、ET-1低于对照组(P<0.05)。液体复苏达标时和达标后24h,ET、vWF有明显降低(P<0.05)。结论PICCO监测指导下液体复苏对脓毒性休克患者炎症因子改善有促进作用,增强机体免疫力,具有临床推广应用价值。Objective To explore the effect of fluid resuscitation guided by PICCO detection on inflammatory factors and immune function in patients with septic shock.Methods The cases were selected from February 2018 to February 2019.92 patients with septic shockadmitted to The fourth hospital of Changsha were randomly divided into two groupsbased:control group(n=46)and research group(n=46).The control group underwent routine fluid resuscitation,and the research group underwent resuscitation guided by PICCO detection.The changes of the patients condition,the expression of CD4+CD25+TREG,miR-155,IL-10,and ET-1 in peripheral blood were compared between the two groups of patients.The levels of ET and vWF before and after resuscitation were compared.Results The research group need less fluid than the control group(P<0.05).However,there were no differences in lactic acid,serum creatinine and other indicators between the two groups of patients(P>0.05).The expression of CD4+CD25+TREG cells and miR-155 in the peripheral blood in the research group was higher than control group(P<0.05),while the expression of IL-10 and ET-1 of the research group were lower than control group(P<0.05).At the time of fluid resuscitation meet the standard and after 24 hour,The ET and vWF decreased significantly(P<0.05).Conclusions Fluid resuscitation guided by PICCO detection can decrease the expression of inflammatory factors in patients with septic shock,enhance the body's immunity,and is worth clinical application.

关 键 词：PICCO监测 液体复苏 脓毒性休克 炎症因子 免疫功能 

分 类 号：R459.7[医药卫生—急诊医学]