抗炎及免疫调理治疗对脓毒症患者T淋巴细胞及细胞因子的影响  

Effects of anti-inflammatory and immunomodulating therapies on T lymphocytes and cytokines in patients with sepsis

作　　者：钟坚 张伟[1] 陈丹 张淑南 陈金成 李少洪[1] ZHONG Jian;ZHANG Wei;CHEN Dan(Emergency Medical Department,Donghua Hospital,Dongguan 523110,China)

机构地区：[1]东莞东华医院急诊医学科,523110

出　　处：《中国实用医药》2021年第24期144-147,共4页China Practical Medicine

基　　金：2018年东莞市社会科技发展重点项目(项目编号:NO.2018507150461630)。

摘　　要：目的探讨抗炎及免疫调理治疗对脓毒症患者T淋巴细胞及细胞因子的影响。方法92例脓毒症患者随机分为观察组与对照组,各46例。对照组使用常规抗感染、补液、血液净化等治疗,在此基础上,观察组使用抗炎及免疫调理治疗。比较两组治疗前、治疗3 d、7 d的T淋巴细胞亚群水平、血清炎性因子水平及病情严重程度。结果治疗3、7 d时,观察组淋巴细胞计数、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均高于对照组,CD8^(+)水平低于对照组,差异具有统计学意义(P<0.05)。治疗3、7 d时,观察组C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平均低于对照组,差异具有统计学意义(P<0.05)。治疗3 d时,观察组急性生理功能和慢性健康状况评分Ⅱ(APACHEⅡ)评分为(16.07±4.93)分、全身性感染相关性器官功能衰竭评分(SOFA)为(26.42±3.79)分均低于对照组的(20.14±5.47)分、(28.97±4.13)分;治疗7 d时,观察组APACHEⅡ评分(11.54±4.32)分、SOFA评分(20.12±3.46)分均低于对照组的(15.67±3.86)分、(25.35±4.01)分;观察组治疗28 d病死率为19.57%,低于对照组的39.13%,差异均具有统计学意义(P<0.05)。结论抗炎及免疫调理治疗对脓毒症患者有显著治疗效果,能明显改善免疫紊乱,增强细胞免疫功能,降低炎性因子水平,减少各项危重评分,降低28 d病死率,值得在临床推广使用。Objective To discuss the effects of anti-inflammatory and immunomodulating therapies on T lymphocytes and cytokines in patients with sepsis.Methods A total of 92 patients with sepsis were randomly divided into observation group and control group,with 46 cases in each group.The control group received conventional antibiotic,fluid replacement,blood purification and other treatments,in addition to whichthe observation group received anti-inflammatory and immunomodulating therapies. The levels of T lymphocyte subsets, serum levels of inflammatory factors before treatment, 3 and 7 d after treatment, and severity of disease were compared between the two groups. Results 3 and 7 d after treatment, the lymphocyte count, CD3^(+), CD4^(+) and CD4^(+)/CD8^(+) of the observation group were higher than those of the control group, and the CD8^(+) was lower than that of the control group, and the difference was statistically significant (P<0.05). 3 and 7 d after treatment, the C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) of the observation group were lower than those of the control group, and the difference was statistically significant (P<0.05). 3 d after treatment, the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score (16.07±4.93) points and sepsis-related organ failure assessment (SOFA) score (26.42±3.79) points of the observation group were lower than (20.14±5.47) and (28.97±4.13) points of the control group;7 d after treatment, the APACHE Ⅱ score (11.54±4.32) points and SOFA score (20.12±3.46) points of the observation group were lower than (15.67±3.86) and (25.35±4.01) points of the control group. The case-fatality rate of the observation group at 28 d of treatment was 19.57%, which was lower than 39.13% of the control group, and the difference was statistically significant (P<0.05). Conclusion Anti-inflammatory and immunomodulating therapies has significant effect on patients with sepsis, and it can significantly improve immune disorders, enhance cellul

关 键 词：脓毒症 抗炎及免疫调理治疗 T淋巴细胞 细胞因子 

分 类 号：R459.7[医药卫生—急诊医学]