连续性血液净化对脓毒症并感染性休克患者免疫功能及细胞因子的影响

Continuous Blood Purification on the Immune Function of Patients with Sepsis and the Impact of Cytokines

目的:探讨连续性血液净化对脓毒症并感染性休克患者免疫功能及细胞因子的影响。方法:选取我院2013年1月-2016年1月收治的60例脓毒症并感染性休克患者作为研究对象,将其随机分为对照组与观察组。给予对照组临床常规治疗,观察组则在此基础上展开连续性血液净化治疗。对两组患者的临床治疗前、后免疫功能及细胞因子变化进行统计与评价。结果:两组患者治疗后CD_3^+、CD_4^+、CD_4^+/CD_8^+T等T淋巴细胞亚群均明显高于治疗前,且比较差异均有统计学意义(P<0.05);观察组患者治疗后CD_3^+、CD_4^+、CD_4^+/CD_8^+T等T淋巴细胞亚群均高于对照组治疗后,且比较差异均有统计学意义(P<0.05);两组患者治疗后内毒素、TNF-α、IL-6、IL-10等细胞因子与治疗前比较差异均有统计学意义(P<0.05);观察组患者治疗后内毒素、TNF-α、IL-6、IL-10等细胞因子与对照组比较差异均有统计学意义(P<0.05)。结论:通过采取连续性血液净化方法对脓毒症并感染性休克患者展开治疗,可有效清除患者循环中的炎性因子和内毒素,提高患者免疫功能,疗效显著,具有重要的临床应用价值。

Objective： To investigate the effects of continuous blood purification on immune function and cytokines in patients with sepsis and septic shock. Methods： 60 patients with septic shock and septic shock admitted in our hospital from January 2013 to January 2016 were randomly divided into control group and observation group. Given the control group of conventional clinical treatment, the observation group on the basis of continuous blood purification treatment. The changes of immune function and cytokines before and after the clinical treatment were statistically analyzed and e- valuated. Results： After treatment,the CD3＋ ,CD4＋ ,CD4 ＋ / CD8＋ T and other T lymphocyte subpopulations in the two groups were significantly higher than before treatment, and the differences were statistically significant （P〈C0. 05）. Af- ter treatment,CD3＋,CD4＋ and CD8 ＋ / CD8＋ T were all higher than those in the control group （P〈0. 05）. After treat- ment, the levels of endotoxin,TNF-α,IL-6,IL-10, and other cytokines in the treatment group were significantly higher than those in the control group （P〈0. 05）, treatment difference was statistically significant （P〈0. 05 ）. Conclusion： Continuous blood purification is a safe and effective method for the treatment of patients with septic shock and septic shock. It can effectively remove the inflammatory factors and endotoxin in the circulation of patients and improve the immunological function of the patients, which has significant clinical application value.