腹腔灌洗术联合持续血液净化对重症急性胰腺炎患者T辅助淋巴细胞及其细胞因子的影响  

Effects of peritoneal lavage combined with continuous blood purification on T helper lymphocytes and cytokines of patients with severe acute pancreatitis

作　　者：张惠清 张新元 王东君 ZHANG Hui-qing;ZHANG Xin-yuan;WANG Dong-jun(General Surgery Department,Xi'an Fengcheng Hospital,Xi'an 710016,China)

机构地区：[1]西安凤城医院普外科

出　　处：《临床医学研究与实践》2020年第3期63-65,共3页Clinical Research and Practice

摘　　要：目的探讨腹腔灌洗术联合持续血液净化对重症急性胰腺炎(SAP)患者T辅助淋巴细胞(Th)及其细胞因子的影响。方法以完全随机数字分组法将符合诊断及纳入标准的102例SAP患者分为对照组和观察组。对照组在常规对症处理基础上采用连续性血液净化治疗,观察组在对照组连续血液净化治疗基础上,采用腹腔灌洗术进行治疗。比较两组治疗前及1、3 d外周血Th1/Th2及Th1细胞因子干扰素-γ(IFN-γ)和Th2细胞因子白细胞介素-4(IL-4)表达水平。结果治疗前,两组外周血Th1/Th2无显著差异(P>0.05);治疗1、3 d,两组外周血Th1/Th2均明显增高,且观察组明显高于对照组(P<0.05)。治疗前,两组Th1细胞因子IFN-γ水平无显著差异(P>0.05);治疗1、3 d,两组Th1细胞因子IFN-γ水平均明显上升,且观察组明显高于对照组(P<0.05)。治疗前,两组Th2细胞因子IL-4水平无显著差异(P>0.05);治疗1、3 d,两组Th2细胞因子IL-4水平均明显下降,且观察组明显低于对照组(P<0.05)。结论腹腔灌洗术联合持续血液净化可有效调整并促进SAP患者机体Th1/Th2平衡,提高机体免疫力。Objective To explore the effects of peritoneal lavage combined with continuous blood purification on T helper lymphocytes(Th) and cytokines of patients with severe acute pancreatitis(SAP). Methods A total of 102 patients with SAP who met the diagnostic and inclusion criteria were divided into control group and observation group by a completely random number grouping method. The control group was treated with continuous blood purification treatment on the basis of routine symptomatic treatment. The observation group was treated with peritoneal lavage on the basis of continuous blood purification of the control group. The peripheral blood T1/Th2, the expression levels of Th1 cytokines interferon-γ(IFN-γ) and Th2 cytokines interleukin-4(IL-4) before and on the first and third day of treatment were compared. Results Before treatment, there was no significant difference in peripheral blood Th1/Th2 between the two groups(P>0.05);on the first and third day of treatment, peripheral blood Th1/Th2 of the two groups increased significantly,and those of the observation group were significantly higher than the control group(P<0.05). Before treatment, there was no significant difference in Th1 cytokines IFN-γ level between the two groups(P >0.05);on the first and third day of treatment, Th1 cytokines IFN-γ level of the two groups increased significantly, and those of the observation group were significantly higher than the control group(P<0.05). Before treatment, there was no significant difference in Th2 cytokines IL-4 level between the two groups(P >0.05);on the first and third day of treatment, Th2 cytokines IL-4 level in both groups decreased significantly, and those in the observation group were significantly lower than the control group(P<0.05).Conclusion Peritoneal lavage combined with continuous blood purification can effectively adjust and promote the Th1/Th2 balance of SAP patients and improve immunity of patients.

关 键 词：重症急性胰腺炎 腹腔灌洗 持续血液净化 T辅助淋巴细胞 细胞因子 

分 类 号：R576[医药卫生—消化系统]