脓毒症休克患者临床免疫功能分析

Analysis on clinical immune function in patients with septic shock

目的观察不同严重程度的脓毒症患者和脓毒症休克患者免疫功能的变化,探讨脓毒症患者免疫功紊乱的发展过程。方法选择脓毒症休克的患者共60例(观察组)和脓毒症患者64例(对照组)。通过观察两组患者之间免疫功能的不同,了解脓毒症对患者免疫功能的影响。结果和对照组相比,观察组T淋巴细胞计数减少(P<0.05),CD3+CD8+细胞下降(P<0.05)。两组患者的CD4+/CD8+比值差异有统计学意义(P<0.05)。观察组B淋巴细胞计数较对照组增多(P<0.05)。两组患者C4及免疫球蛋白M(IgM)比较差异有统计学意义(P<0.05)。两组患者白细胞、降钙素原、C反应蛋白的差异有统计学意义(P<0.05)。脓毒症休克患者降钙素原浓度与补体、抗体相关性分析,补体C3与降钙素原呈相关(P<0.05)。结论脓毒症休克存在严重的免疫紊乱,不仅有免疫抑制,而且存在自身免疫倾向。同时,C3和脓毒症休克严重程度具有相关性,对判断脓毒症休克严重程度具有潜在价值。

Objective To observe the changes of immune function in the patients with different severity degrees of sepsis and septic shock.Methods Sixty patients with septic shock（observation group）and 64 patients with sepsis（control group）were selected.The influence of sepsis on immune function was understood by observing the differences of the immune function between the two groups.Results Compared with the control group,T lymphocytes count in the observation group was decreased（P〈0.05）.CD3＋CD8＋T lymphocytes in the observation group were decreased compared with the control group（P〈0.05）.The difference of CD4＋/CD8＋ratio had statistical difference between the two groups（P〈0.05）.The B lymphocytes count in the observation group was increased compared with the control group（P〈0.05）.C4 and IgM had statistical difference between the two groups（P〈0.05）.The WBC count,C reactive protein had statistical difference between the two groups（P〈0.05）.The correlation analysis of procalcitonin concentration,complements and antibodies showed that complement 3had a correlation with procalcitonin（P〈0.05）.Conclusion The severe immune function disorder exists in septic shock,including immune inhibition and autoimmunity trend.Meanwhile complement 3is correlated with the severity degree of septic shock,which has a potential value to judge the severity degree of septic shock.