脓毒症患者连续性血液净化治疗后休克指数与全身炎症反应综合征、免疫应答的相关性

Shock index of sepsis patients after continuous blood purification treatment and its relationship with systemic inflammatory response syndrome and immune response

目的:探讨脓毒症患者连续性血液净化(CBP)治疗后休克指数与全身炎症反应综合征、免疫应答的相关性。方法:选取在本院接受连续性血液净化治疗的脓毒症患者88例,均接受CBP治疗,对比治疗前后休克指数(SI)、根据治疗后SI水平分为SI>0.5分的休克组患者27例、SI≤0.5分的非休克组61例。对比两组患者的治疗后血清炎症介质、Th1/Th2细胞免疫指标、免疫球蛋白及补体含量差异。结果:脓毒症患者治疗后SI水平显著低于治疗前(P<0.05)。非休克组患者血清中炎症介质PCT、CRP、HMGB1的含量低于休克组患者,Th1细胞因子IL-2、IFN-γ的含量高于休克组患者,Th2细胞因子IL-10、IL-13的含量低于休克组患者,IgG、IgM、IgA、C3、C4的含量高于休克组患者(P<0.05)。结论:脓毒症患者CBP治疗后SI水平下降,且具体SI水平与全身炎症反应综合征、免疫应答水平直接相关。

Objective：To study the Shock index of Sepsis patients after Continuous blood purification（CBP）treatment and its relationship with Systemic inflammatory response syndrome,immune response.Methods：A total of 88 cases of Sepsis patients in our hospital during June 2012 to May 2016 year underwent continuous blood purification treatment were chosen as research subject,shock index（SI）was compared before and after the treatment,according to the level of SI after treatment all patients were divided into shock group（n=27）with SI0.5,no shock group（n=61）with SI≤0.5.Serum inflammatory mediators,Th1/Th2 cell immune indexes,immunoglobulin and complement contents between two groups after treatment were compared.Results：The levels of SI in patients with sepsis were significantly lower than that before treatment（P〈0.05）.Serum contents of inflammatory mediators such as PCT,CRP,HMGB1 in no shock group were lower than those in shock group,contents of Th1 cytokines IL-2,IFN-γwere higher than those in shock group,contents of Th2 cytokines IL-10,IL-13 were lower than those in shock group,contents of IgG,IgM,IgA,C3,C4 were higher than those in shock group（P〈0.05）.Conclusion：The level of SI decreased in the patients with sepsis after CBP treatment,and the SI level was directly related to the systemic inflammatory response syndrome and the level of immune response.