持续性血液净化对重症脓毒症患者的疗效及对免疫、炎症状态的影响

Efficacy of continuous blood purification in patients with severe sepsis and its effect on immune and inflammatory state

目的研究持续性血液净化(CBP)对重症脓毒症患者的疗效及对免疫、炎症状态的影响。方法将山东省单县东大医院2018年4月3日-2020年1月12日收治的73例重症脓毒症患者纳入研究,将其按照电脑随机数字表法分作研究组36例和常规组37例。常规组开展常规治疗,研究组在常规组的基础上增用CBP治疗。分析两组疗效,治疗前后免疫、炎症以及微循环状态变化情况等方面的差异。结果研究组治疗后氧合指数高于常规组,APACHEⅡ评分低于常规组(均P<0.05)。治疗后,研究组CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)均高于常规组(均P<0.05)。治疗后,研究组血清IL-6及CRP水平均低于常规组(均P<0.05)。治疗后,研究组微血管流动率及灌注血管比重均高于常规组(均P<0.05)。结论CBP治疗重症脓毒症患者的疗效较佳,有助于改善患者的免疫、炎症状态,同时促进微循环状态的恢复。

Objective To study the effect of continuous blood purification(CBP)on patients with severe sepsis and the effect on immune and inflammatory state.Methods A total of 73 patients with severe sepsis admitted to our hospital from April 3,2018 to January 12,2020 were included in this study.According to computer random number table method,36 cases were divided into study group and 37 cases were conventional group.The conventional group received conventional treatment,while the study group received additional CBP treatment on the basis of conventional group.The difference of curative effect,immunity,inflammation and microcirculation before and after treatment were anaylyzed between the two groups.Results The study group after treatment of oxygenation index were higher than in conventional group,the APACHEⅡscores were lower than conventional group(all P<0.05).After treatment,CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the study group were higher than conventional group(all P<0.05).Serum IL-6 and CRP levels in the study group were lower than conventional group after treatment(all P<0.05).After treatment,the microvascular flow rate and the proportion of perfusion vessels in the study group were higher than conventional group(all P<0.05).Conclusion CBP is effective in the treatment of patients with severe sepsis,which is helpful to improve the immune and inflammatory state of patients,and promote the recovery of microcirculation state.