调整免疫抑制剂对肝移植感染全身炎症反应综合征的影响

Effects of Withdrawing Immunosuppressants on Inflammatory Indexes in Liver Transplantation Infection

目的探讨停用免疫抑制剂对肝移植感染炎症指标的影响。方法根据多器官功能障碍综合征(MODS)评分法对肝移植感染患者进行评分,当MODS 13～16分时停用免疫抑制剂(26例,停用组),观察患者体温、心率、呼吸和外周血白细胞的变化,并与感染未停用免疫抑制剂(13例,常规组)的患者比较。结果感染后,加强抗感染治疗或同时停用免疫抑制剂均可改善患者的体温、心率、呼吸和外周血白细胞(P<0.05),但同时停用免疫抑制剂则更利于体温、心率、呼吸和外周血白细胞的改善(P<0.05)。结论肝移植感染者,在加强抗感染治疗的基础上,同时停用免疫抑制剂更有利于控制感染。

OBJECTIVE To explore the effects of withdrawing immunosuppressants on the inflammatory indexes.METHODS Based on the MODS score,the infections of liver transplantation were scored.When the MODS scores reached 13-16,the immunosuppressants were withdrawn in 26 infectious cases（test group）,and the patients′ temperatures,heart rates,breathing rates and white blood cells were recorded daily.All of them were compared to the previous no with drawing immuno group（13 cases,control group）.RESULTS After making the definite diagnoses of infections and strengthening the anti-infection treatment,suppressants both two groups could normalize the patients′ temperatures,heart rates,breathing rates and WBC（P0.05）;but the test group could do better（P0.05）.CONCLUSIONS For the infection of liver transplantation,strengthening anti-infection treatment,and simultaneously,withdrawing immunosuppressants could do more favor for the infection control.