摘要
目的探讨高容量血液滤过（HVHF）对MODS患者Th，和Th1细胞凋亡率的影响。方法对12例多器官功能障碍综合征（MODS）患者在2次HVHF治疗前和开始后8h动脉采血，分离、提纯外周血CD4^＋T淋巴细胞，应用免疫组织化学技术及TUNEL法双染动态观察外周血Th1、Th2细胞百分比和凋亡率的变化。结果2次HVHF前后对比平均动脉压差异无统计学意义（P均〉0．05），而心率、氧合指数、血肌酐、血清CRP水平、APACHEⅡ评分均有明显改善（P均〈0．05）；2次HVHF前后对比Th1细胞百分比均升高，而Th2细胞百分比均下降（P均〈0．05）；2次HVHF前后对比Th1细胞凋亡率均下降（P均〈0．05），而Th2细胞凋亡率差异无统计学意义（P均〉0．05）；Th1细胞凋亡率与其百分比呈强相关（r=-0．876，P〈0．05）。结论HVHF治疗可以降低Th．细胞凋亡率，而对Th2细胞凋亡率无明显影响，这种差异性可能是HVHF治疗逆转Th1向Th2漂移，重建免疫平衡的机制之一。
Objective To evaluate the effect of high volume hemofihration （HVHF） on the apoptosis of Th1 and Th2 cell in the patients with MODS. Methods 12 patients with MODS treated with two times HVHF was studied. Some important clinical parameters were observed. The percentage and apoptosis of Th1 ,Th2 cells were measured before the treatment and 8 h after HVHF each time. Results In the patients undergoing HVHF each time, MAP did not change （ P 〉 0. 05 ） , and HR, PaO2/FiO2, SCr, C - creative protein, APACHE Ⅱchanged （ P 〈 0. 05 ）. The percentage of Th1 cell increased and Th2 cell decreased（ P 〈 0. 05）. The percentage of Th1 cell apoptosis decreased （P 〈 0. 05） and Th2 cell did not significantly change（ P 〉 O. 05）. There was a negative relationship between the percentage of Th1 cells and its apoptosis （ r = - 0. 876,P 〈 0.05）. Conclusion HVHF can decrease the apoptosis of Th1 cell, but have no effect on the apoptosis of Th2 cell. The differences are induced by HVHF treatment which reverse the shift（ Th1 to Th2 ） and rebuild the immune balance.
出处
《中国急救医学》
CAS
CSCD
北大核心
2009年第9期832-835,共4页
Chinese Journal of Critical Care Medicine
