摘要
目的探讨连续性血液净化(CBP)改善脓毒症患者病情及内质网应激的研究。方法2019年5月至2021年5月间在中国人民解放军陆军第八十二集团军医院接受CBP治疗的脓毒症患者110例作为脓毒症组,同期在本院进行体检的健康志愿者100名作为健康对照组。对比脓毒症患者治疗前、治疗72 h的急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)、序贯器官功能衰竭(SOFA)评分差异。对比脓毒症、健康对照组的外周血炎症因子[白介素-1(IL-1)、IL-10、肿瘤坏死因子α(TNF-α)]、免疫功能指标[CD4^(+)、CD8^(+)T淋巴细胞分布比例,CD4^(+)/CD8^(+)比值]以及外周血单个核细胞(PBMC)内质网应激相关分子表达水平[葡萄糖调节蛋白78(GRP78)、C/EBP同源蛋白(CHOP)、含半胱氨酸的天门冬氨酸蛋白水解酶-12(Caspase-12)]的差异。结果脓毒症患者治疗72 h的APACHEⅡ、SOFA评分值分别低于治疗前(P<0.05)。治疗72 h,脓毒症患者的外周血IL-1、TNF-α水平低于治疗前,IL-10水平高于治疗前(P<0.05);脓毒症患者的外周血CD4^(+)T淋巴细胞计数、CD4^(+)/CD8^(+)比值分别高于治疗前(P<0.05);脓毒症患者的PBMC GRP78、CHOP、Caspase-12 mRNA表达量低于治疗前(P<0.05)。结论CBP可减轻脓毒症患者的病情,可能与其抑制内质网应激的作用机制相关。
Objective To investigate the efficacy of continuous blood purification(CBP)in improving the morbidity and endoplasmic reticulum stress in patients with sepsis.Methods Included were 110 septic patients who underwent CBP in The PLA 82nd Army Group Military Hospital between May 2019 and May 2021(sepsis group)and 100 contemporary healthy volunteers who underwent physical chekup in our hospital(normal control group).Acute Physiology and Chronic Health Evaluation(APACHE)II and sequential organ failure assessment(SOFA)scores in the septic pa-tients before and at 72 hours after treatment were compared.Peripheral blood in-flammatory factors[interleukin-1(IL-1),interleukin-10(IL-10),tumor necrosis factor alpha(TNF-α)],immune function indexes[proportions of CD4^(+)and CD8^(+)T Lymphocytes,CD4^(+)/CD8^(+)ratio]and the expression levels of en-doplasmic reticulum stress-related molecules(GRP78,CHOP,Caspase-12)in peripheral blood mononuclear cells(PBMC)were compared between the sepsis group and the normal control group.Results The APACHE II and SOFA scores in septic patients at 72 hours after treatment were lower than baseline(P<0.05).At 72 hours after treatment,the peripheral blood levels of IL-1 and TNF-αin the septic patients were lower,the level of IL-10 was higher(P<0.05),the peripheral blood CD4^(+)T lymphocyte count and CD4^(+)/CD8^(+)ratio were higher(P<0.05),com-pared with baseline.The septic patients also showed lower mRNA expression levels of GRP78,CHOP,and Cas-pase-12 in PBMC compared with baseline(P<0.05).Conclusion CBP can alleviate the morbidity of patients with sepsis,probably via inhibition of endoplas-mic reticulum stress.
作者
康亚洁
赵朝
Kang Yajie;Zhao Chao(Department of Cardiology and Nephrology,The PLA 82nd Army Group Military Hospital,071000 Baoding,China;Department of Respi-ratory Medicine,Baoding People′s Hospital,Baoding 071000,Hebei,China)
出处
《中国药物与临床》
CAS
2022年第6期527-531,共5页
Chinese Remedies & Clinics
关键词
脓毒症
连续性肾替代疗法
内质网应激
Sepsis
Continuous Renal replacement therapy
Endoplasmic reticulum stress
