低分子肝素对脓毒症患者免疫功能的影响

Effect of low molecular heparin on immune function of patients with sepsis

目的评价低分子肝素对脓毒症患者免疫功能及预后的影响。方法选取2013年1月至2013年6月入院的脓毒症患者40例,分为低分子肝素组及对照组,于治疗前及治疗第3、7d使用流式细胞仪检测脓毒症患者使用低分子肝素前后T淋巴细胞亚群、NK细胞、B淋巴细胞的变化,同时统计患者APACHEⅡ评分、28d病死率、ICU住院时间。比较两组患者T淋巴细胞亚群、B淋巴细胞、NK细胞变化情况及与APACHEⅡ评分及28d病死率、ICU住院时间变化。结果两组患者的T淋巴细胞亚群、B淋巴细胞、NK细胞随积极治疗后逐步升高,但两组间比较无统计学差异(P>0.05)。组间比较APACHEⅡ评分无统计学差异(P>0.05),但低分子肝素组APACHEⅡ评分下降明显优于对照组,且低分子肝素组治疗前后APACHEⅡ评分改变有统计学差异(P<0.05)。低分子肝素组患者住ICU时间、病死率均比对照组低,但两组间比较差异均无显著性(P>0.05)。结论低分子肝素用于脓毒症患者的治疗能改善患者的APACHEⅡ评分、28d病死率、ICU住院时间,但无统计学差异,对免疫功能的影响有待进一步的研究。

Objective To evaluate the effect of low molecular heparin on immune function and prognosis of patients with sep-sis. Method 40 hospitalized patients with sepsis from Jan 2013 to June 2013,were divided into low molecular heparin group and control group,before treatment and at third and seventh day using flow cytometry to test the change of T lymphocyte subsets,NK cells,B lymphocytes before and after using low molecular weight heparin of patients with sepsis. and at the same time make statis-tics which were APACHE Ⅱscore,28d mortality and length of time in the ICU. To compare two group patients’ change of T lym-phocyte subsets,B lymphocytes and NK cells,and the change of APACHE Ⅱscore and 28d mortality, length of hospitalized time in the ICU. Results T lymphocyte subsets,B lymphocytes,NK cells of two groups patients with active treatment were gradually increased,but the two groups had no statistical difference（P〉0.05）. Comparison between groups of APACHE Ⅱ score were no sig-nificant difference （P〉0.05）,but the low molecular heparin group APACHE II score were lower than that of the control group,and the change of APACHE Ⅱ score of low molecular heparin group before and after treatment was statistically significant difference （P〈0.05）. Length of hospitalized time in the ICU and mortality of low molecular heparin group were lower than that of control group,but there was no significant difference between two groups（P〉0.05）. Conclusion The treatment of low molecular heparin on patients with sepsis can improve the patient＇s APACHE Ⅱscore,28d mortality,length of hospitalized time in the ICU,but there is no significant difference,the effects on the immune function are needed to do further study.