连续性血液净化对儿童全身炎症反应综合征T细胞亚群的影响

Effects of continuous blood purification on T-cell subsets in children with systemic inflammatory response syndrome

目的探究连续性血液净化对T细胞亚群的影响。方法收集我院收治的全身炎症反应综合征(SIRS)的患儿24例根据随机对照表分为对照组和试验组,每组各12例。对照组患儿予常规治疗,试验组在对照组的基础上采用床旁血滤机进行连续性血液净化治疗,治疗时间不少于24 h。治疗结束后,对比分析2组患儿血常规、C反应蛋白(CRP)、T细胞亚群以及不良反应的发生情况。结果试验组存活8例,死亡3例,放弃治疗1例;对照组存活5例,死亡5例,放弃治疗2例。试验组与对照组前后比较CRP、白细胞计数、中性粒细胞计数,CD3+、CD4+、CD19+/CD45+、CD3+/CD45+、NK细胞变化差异有统计学意义(P<0.05)。结论连续性血液净化治疗可降低SIRS患儿血液中炎症相关指标,下调机体的炎症反应,减轻过度激活的炎症介质对机体的影响,同时可上调T细胞亚群水平,改善机体免疫功能,促进患儿自身免疫功能的恢复,改善患儿的预后。

Objective To investigate effects of continuous blood purification(CBP) on T-cell subsets in children with systemic inflammatory response syndrome. Methods A total of 24 children with systemic inflammatory response syndrome in our hospital were randomly divided into control group and experimental group, with 12 patients in each group. Patients in the control group were given conventional treatment, while the experimental group was treated with CBP on the basis of the control group, and the treatment duration was not less than 24 hours. After treatment, white blood-cell counts, C reactive protein(CRP), T-cell subsets and adverse reactions of the two groups were compared and analyzed. Results In the treament group, 8 cases survived, 3 cases died and 1 case gave up treatment. In the coutrol group, 5 cases were survived, 5 cases died and 2 cases gave up treatment. The significant differences were observed in the changes of CRP, WBC, neutophil, CD3^+, CD4^+, CD19^+/CD45^+, CD3^+/CD45^+, NK between two groups. Conclusion CBP can reduce the inflammatory markers in the blood of children with systemic inflammatory response syndrome, down-regulate the body′s inflammatory response and reduce the effect of overactive inflammatory mediators on the body. At the same time, CBP can raise the level of T-cell subsets, improve the immune function, promote the recovery of autoimmune function in children, and improve the prognosis of children.