CVVH对MODS患者HMGBl介导的T淋巴细胞亚群变化的影响

Effects of continuous veno - venous hemofiltration on the changes of T cell subgroup mediated by HMGB1 in patients with multiple organ dysfunction syndrome

目的探讨连续性静脉-静脉血液滤过（CVVH）对多器官功能障碍综合征（MODS）患者高迁移率族蛋白B1（HMGBl）表达和T淋巴细胞亚群的影响。方法40例符合MODS诊断标准的ICU患者，均行CVVH治疗。于CVVH前、CVVH治疗8h及结束治疗后8h分别测定HMGBl和T淋巴细胞亚群。结果HMGBl能影响外周血T淋巴细胞亚群变化。CVVH治疗后血清TNF-α、IL-1、IL-6及HMGBl浓度降低，CD3＋／CD4＋、CD3-／CDl6＋上升，CD3＋／CD8＋下降；TH／TS比值升高，且至16h差异无统计学意义（P=0．811）。结论CVVH可降低MODS患者的HMGBl浓度，调节HMGBl介导的细胞免疫紊乱，重建免疫平衡。

Objective To investigate the effects of continuous veno - venous hemofihration （CVVH） on the levels of serum high mobility group box- 1 protein （HMGB1） and the changes of each T -lymphocyte subset in patients with muhiple organ dysfunction syndrome （MODS）. Methods Forty patients with MODS in intensive care unit were scheduled for the treatment with CVVH, the levels of HMGB1 and the percent of each T - lymphocyte subset were identified on the point of pre - CVVH （0 h）, the eighth hour of CVVH （8 h） and 8 h after CVVH therapy （16 h）. Results The percent of peripheral blood T - lymphocyte subsets were altered by the stimulation of HMGB1. After CVVH treatment, the levels of serum TNF alpha, IL - 1, IL - 6 and HMGB1 were decreased, the percent of CD3 ＋/CD4 ＋ , CD3 -/CD16＋ was increased, and the percent of CD3 ＋/CD8 ＋ was decreased; but there was an continuous increasing in ratio of TH/TS. Conclusion CVVH could reduce the HMGB1 levels of patients with MODS, regulate cellular immune disorder mediated by HMGB1, and rebuild the immune balance.