连续性血液净化治疗对脓毒症患者炎性因子及免疫功能的影响

Effect of Continuous Blood Purification on Inflammatory Factors and Immune Function in Patients with Sepsis

目的:探究连续性血液净化(CBP)治疗对脓毒症患者炎性因子及免疫功能的影响,为临床治疗脓毒症提供参考。方法:选取2014年6月-2016年12月我院ICU收治的76例严重脓毒症患者,根据患者所采用的治疗方式分为常规组(n=36)与CBP组(n=40)。常规组患者采取目标针对性治疗和生命支持治疗,CBP组在目标针对性治疗的基础上采用CBP治疗。检测并比较治疗前和治疗3 d后两组患者白介素-6(IL-6)、白介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)和C反应蛋白(CRP)水平。检测并比较治疗前和治疗3 d后两组患者CD3^+,CD4^+,CD8^+T细胞并计算CD4^+/CD8^+比值。结果:两组治疗前的血清炎性因子水平均无统计学差异(P>0.05)。治疗3 d后两组的血清炎性因子水平均明显下降,且CBP组的IL-6、TNF-α和CRP水平均明显低于常规组(P<0.05)。常规组与CBP组治疗前的免疫功能指标均无统计学差异(P>0.05)。治疗3 d后两组患者CD3^+、CD4^+以及CD4^+/CD8^+比值均明显升高,且CBP组的CD4^+及CD4^+/CD8^+比值明显高于常规组(P<0.05)。结论:CBP应用于脓毒症的治疗,可明显改善患者体内炎性因子的表达,并能明显改善患者的免疫功能,促进患者免疫功能的恢复。

Objective：To investigate the effect of continuous blood purification （CBP） on inflammatory factors and immune function in patients with sepsis,in order to provide reference for clinical treatment of sepsis.Methods：A total of 76 patients with severe sepsis,who were treated in ICU of Daqing Oilfield General Hospital from June 2014 to December 2016,were selected.The patients were divided into conventional group （n=36） and CBP group （n=40） according to the received treatment method.The patients in the conventional group were treated with targeted therapy and life support,while the patients in the CBP group were treated with CBP on the basis of targeted therapy.The levels of interleukin-6 （IL-6）,interleukin-10 （IL-10）,tumor necrosis factor-α （TNF-α） and C reactive protein （CRP） of the patients in the two groups were detected and compared before treatment and after 3d of treatment.The CD3＋,CD4＋,CD8＋T cell and the CD4＋/CD8＋ ratio before treatment and after 3 d of treatment were calculated and compared between the two groups.Results：There was no significant difference in the level of serum inflammatory factors between the two groups before treatment （P〉0.05）.The levels of serum inflammatory factors in the two groups were significantly decreased after 3 d of treatment,and the levels of IL-6,TNF-α and CRP in the CBP group were significantly lower than those in the conventional group （P〈0.05）.There was no significant difference in immune function indexes between the conventional group and the CBP group before treatment （P〉0.05）.After 3d of treatment,CD3＋,CD4＋ and CD4＋/CD8＋ ratio were significantly increased in the two groups,and the CD4＋ and CD4＋/CD8＋ ratio of the CBP group were sig-nificantly higher than those of the conventional group （P〈0.05）.Conclusion：The application of CBP in the treatment of patients with sep-sis can obviously improve the expression of inflammatory factors of patients,and can improve the immune function and promote the re-covery of immune function.