摘要
目的探究连续性血液净化对脓毒症并感染性休克患者免疫功能及细胞因子的影响。方法选取我院2016年1月至2018年12月间收治的70例脓毒症合并感染性休克患者,按数字单双号法分为对照组(35例)和实验组(35例)。对照组实施常规疗法,实验组在常规疗法的基础上实施连续性血液净化治疗,比较两组的免疫功能和细胞因子水平及不良反应和预后情况。结果治疗前,两组CD3+、CD4+、CD8+、CD4+/CD8+比较,差异无统计学意义(P>0.05);治疗后,两组CD3+、CD4+、CD4+/CD8+均较治疗前升高,CD8+均较治疗前降低。实验组CD3+、CD4+、CD4+/CD8+高于对照组,CD8+低于对照组,差异有统计学意义(P<0.05)。治疗前,两组CRP、IL-6、TNF-α相比较,差异无统计学意义(P>0.05);治疗后,两组CRP、IL-6、TNF-α均低于治疗前,实验组低于对照组,差异有统计学意义(P<0.05)。对照组并发症发生率为11.43%(4/35),1年后生存率为91.43%(32/35);实验组并发症发生率为14.29%(5/35),1年后生存率为94.29%(33/35),实验组均高于对照组,但差异无统计学意义(P>0.05)。结论连续血液净化治疗脓毒症并感染性休克,可改善患者免疫功能低下的状态,抑制机体内细胞炎性因子的表达,安全性较高,预后良好,值得推广。
Objective To investigate the effects of continuous blood purification on immune function and the expression of cytokines in patients with sepsis and septic shock.Methods Seventy patients with sepsis and septic shock admitted to our hospital from January 2016 to December 2018 were enrolled.The patients were divided into control group(35 cases)and experimental group(35 cases)according to the number single and double numbers.The control group was treated with conventional therapy.The experimental group was treated with continuous blood purification on the basis of conventional therapy.The immune function,the expression of cytokine,the adverse reactions and prognosis were compared between the two groups.Results Before treatment,there was no significant difference in CD3+,CD4+,CD8+,CD4+/CD8+between the two groups(P>0.05).After treatment,CD3+,CD4+,CD4+/CD8+in both groups were higher than those before treatment,and CD8+was lower than before treatment.CD3+,CD4+,CD4+/CD8+in the experimental group was higher than that in the control group,CD8+was lower than that in the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in CRP,IL-6 and TNF-αbetween the two groups(P>0.05).After treatment,CRP,IL-6 and TNF-αwere lower than those before treatment.The difference was statistically significant(P<0.05).The complication rate in the control group was 11.43%(4/35),and the survival rate after 1 year was 91.43%(32/35).The complication rate in the experimental group was 14.29%(5/35),and the survival rate after 1 year.94.29%(33/35),the experimental group was higher than the control group,but the difference was not statistically significant(P>0.05).Conclusion Continuous blood purification for the treatment of sepsis and septic shock can improve the immune function of patients and inhibit the expression of cellular inflammatory factors in the body.It has high safety and good prognosis.It is worthy of promotion.
作者
郑志忠
吴寿坤
伍荣乐
王圳豪
谭先念
ZHENG Zhi-zhong(Department of Critical Care Medicine,Taishan People′s Hospital,Jiangmen 529200,China)
出处
《牡丹江医学院学报》
2019年第6期43-45,共3页
Journal of Mudanjiang Medical University
基金
江门市科技计划项目(20191011)
