摘要
目的:探讨连续性血液净化对老年感染性休克外周血T淋巴细胞亚群影响观察。方法:选择2009年6月至2010年12月我院ICU收住的老年感染性休克患者30例。全部患者均予以病因治疗,针对病原菌采用积极的抗感染、扩容、纠正酸中毒、使用血管活性药物、机械通气辅助呼吸治疗、液体复苏及营养支持等治疗。同时采用连续性血液净化治疗。采用流式细胞术测定外周静脉血T细胞亚群(CD3+、CD4+、CD8+)。结果:本组研究30例均完成连续性血液净化治疗,14d时生存14例,病死率53.33%,治疗过程中均未发现消化道出血、恶性心律失常、循环不稳定等相关想不良耐受副反应;CBP治疗后APACHEⅡ评分及MODS评分均明显下降(P<0.05);血气分析较治疗前稳定,血PH值、氧合指数、肌酐、尿素氮等指标较前明显改善,差异均有统计学意义(p<0.05;p<0.01);CBP治疗后外周血T淋巴细胞亚群中CD3+和CD4+较治疗前明显升高,CD8+明显降低,治疗前后比较差异均有显著性(p<0.05)。结论:连续性血液净化治疗能够有利于老年感染性休克患者纠正机体免疫功能失衡,改善机体的免疫功能,值得临床推广使用。
Objective：To explore the observation and effect of persistent blood purification on T lymphocyte subpopulation of peripheral Wood in the old patients with septic shock.Methods：30 old patients with septic shock hospitalized at ICC of our hospital from June 2009 to December 2010 were;selected as the subjects.All patients received etilogical treatment including positive anti-infection, diiatancy,rectifying acidosis,using vasoactive agents,mechanical ventilation assisted respiration,liquid resuscitation and nutritional support and so on.At the same time,persistent blood purification was adopted.Flow cytometry was used to detect T lymphocyte subpopulation（CD3＋,CD4＋,CD8＋） of peripheral blood.Results：All patients received whole persistent blood purificatioh treatment and 14 patients survived at fourteenth day with 53.33%as case fatality.There was no alimentary tract hemorrhage,malignant arrhythmia. instable circulation and related adverse effects during treatment;APACHE II and MODS scores decreased obviously after CBP treatment （P0,05）;postoperative blood gas analysis was more stable compared with that of pretreatment and postoperative PH value,oxygenation index,creatinine and urea nitrogen were all improve evidently compared with that of pretreatment with statistical significance（P0.05; P0.01）;CD3＋ and CD4＋ increased after CBP and CD8＋ decreased significantly compared with that of pretreatment with significant difference（P0.05）.Conclusions：Persistent blood purification has advantages to rectify immune dysfunction,improve immune function in old patients with septic shock and has potential extensive application in clinical practice.
出处
《中国医药导刊》
2011年第12期2096-2097,2099,共3页
Chinese Journal of Medicinal Guide
