连续性血液净化治疗对脓毒症患者细胞免疫功能的影响

Effect of continuous blood purification on immune function in the patients with severe sepsis

目的探讨连续性血液净化(CBP)治疗对脓毒症患者细胞免疫功能的影响。方法对21例脓毒症患者在CBP治疗前后采血,用流式细胞术测定T淋巴细胞亚群CD3^+、CD4^+、CD8^+、CD4^+/CD8^+比值,同时检测血及废液中肿瘤坏死因子-α(TNF-α)浓度,观察CBP治疗前后T淋巴细胞亚群、TNF-α的变化。结果CBP治疗后APACHEⅡ评分降低(P＜0．001),CD3^+、CD4^+、CD4^+/CD8^+比值均较CBP治疗前升高(P＜0．001、P＜0．001、P＜0．05),而CD8^+差异无统计学意义(P＞0．05),TNF-α浓度无明显变化(P＞0．05)。结论CBP治疗可以改善脓毒症患者的细胞免疫功能,对T淋巴细胞亚群具有双向调节作用。

Objective To evaluate the effect of continuous blood purification （CBP） on immune funetion in the patients with severe sepsis. Methods APACHE Ⅱ seore, TNF - α and some parameters of immune function of pre - CBP, post - CBP were studied and compared in 21 patients with severe sepsis. Results CD3^＋ , CD4 ^＋ , CD4 ^＋/CD8^＋ ratio were higher in post - CBP than those in pre - CBP （P 〈0. 001 ,P 〈0. 001 ,P 〈0.05 ） , there were no significant differenees in CD8^ ＋ and TNF - α between the pre - CBP and post - CBP（ P 〉 0.05 ） , but APACHE Ⅱ seore was lower in the post - CBP than in pre - CBP （ P 〈 0. 001 ）. Conclusion CBP is one of effective methods for the patients with severe sepsis, and ean improve the eellular immune function of these patients, eorreet the inbalanee of CD4 ^＋/CD8^＋ ratio, and has the effeet of bidirectional regulation on T -eell subgroup.