早期强化胰岛素治疗对重症脓毒症患者单核细胞mCD14、HLA-DR表达的影响

Effect of intensive insulin therapy at early stage on the expression of monocytes mCD14 and HLA-DR in patients with severe sepsis

目的探讨早期强化胰岛素治疗对重症脓毒症患者外周血单核细胞mCD14、HLA-DR表达的影响。方法选择重症脓毒症患者50例,随机分为强化胰岛素组(强化组)和常规胰岛素治疗组(常规组)每组25例,流氏细胞术检测单核细胞mCD14、HLA-DR表达,同时记录ApachⅡ评分和病死率。结果重症脓毒症患者单核细胞mCD14、HLA-DR表达率明显降低(P<0.05或0.01),强化组ApachⅡ评分及病死率均明显降低(P<0.05),单核细胞mCD14、HLA-DR表达率较常规组明显升高(P<0.05或<0.01)。结论早期强化胰岛素治疗可以更好的改善机体的免疫功能,提高生存率,改善预后。

Objective To investigate the effect of intensive insulin therapy at early stage on the expression of monocytes mCD14 and HLA-DR in patients with severe sepsis.Methods Fifty patients with severe sepsis were randomly divided into intensive insulin therapy group（n=25）and control group（n=25）.The expression monocytes mCD14 and HLA-DR in peripheral blood of patients by flow cytometry,and ApachⅡscores and mortality were recorded during the study.Results The expression rates of monocytes mCD14 and HLA-DR were significantly decreased in patients with severe sepsis,as compared with those in control group（P〈0.05）.The expression rates of monocytes mCD14 and HLA-DR in patients receiving intensive insulin therapy were significantly increased,as compared with those in patients without treatment（P〈0.05 or P〈0.01）.Conclusion Intensive insulin therapy at early stage can obviously improve immune functions of patients with severe sepsis,increase survival rate and improve prognosis.