中国免疫学杂志2016，Vol.32Issue(11)：1661-1666,6.DOI:10.3969/j.issn.1000-484X.2016.11.021
血液净化对脓毒症患者凝血功能及免疫功能的影响
Effect of continuous blood purification on coagulation function and immune function in patients with sepsis
摘要
Abstract
Objective:To explore the functions of continuous blood purification ( CBP ) on blood coagulation function and immune function of patients with sepsis.Methods: From January 2012 to January 2015 , 54 patients who were hospitalized in the intensive care unit ( ICU) of the first division hospital of Xinjiang Crops that in accordance with the diagnostic criteria of sepsis were enrolled into this experiment.All the patients were treated with CBP ,and their APACHEⅡscores before treatment and 12 h,24 h,48 h and 72 h after treatment were measured with persistent observation ,respectively.Blood were collected from patients in different times after CBP treatment.The peripheral blood immune cells (CD4+/CD8),the levels of secreted cytokines (IL-1,IL-6,IL-10 and TNF-α), the coagulation function index ( APTT,TT,PT) and FIB were detected by flow cytometry ,ELISA,coagulation method and immunoturbi-dimetry,respectively.Results:The levels of PT,APTT,TT,and FIB of sepsis patients before CBP treatment were higher than those of healthy people (all P<0.05).Compared with before CBP treatment,the coagulation function indexes (PT,APTT,TT and FIB) were significantly reduced after CBP treatment for 12,24,48 and 72 h(all P<0.05).The frequencies of CD3+,CD4+and CD4+/CD8+cells in the sepsis group were significantly lower than those in the healthy group (all P<0.05).After CBP treatment for 12,24,48 and 72 h, the frequencies of CD3+T and CD4+T cells were gradually increased when compared with those before CBP treatment (all P<0.05), while the CD4+/CD8+ratio was significantly higher than that before CBP treatment (all P<0.05).The frequencies of CD3+,CD4+and CD4+/CD8+cells before CBP treatment and with CBP treatment for 12,24 and 48 h were lower than those in the healthy group (all P<0.05).After CBP treatment for 12,24,48 and 72 h,the levels of IL-1,IL-6 and IL-10 were lower than those before CBP treatment( all P<0.05).After CBP treatment for 48 h and 72 h,the levels of TNF-αwere lower than those before CBP treatment (both P<0.05).The levels of IL-1 before CBP treatment and with CBP treatment for 12 ,24 and 48 h were higher than those in the healthy group ( all P<0.05),while the levels of IL-6 and L-10 before CBP treatment and with CBP treatment for 12,24,48 and 72 h were higher than those in the healthy group ( all P<0.05 ).The levels of TNF-αbefore CBP treatment and with CBP treatment for 12 h and 24 h were higher than those in the healthy group (both P<0.05).After CBP treatment for 12,24,48 and 72 h,the APACHEⅡscore were significantly lower than those before CBP treatment ( all P<0.05 ).Conclusion: Our study provide strong evidence that CBP is helpful to improve the condition and enhance immune function of patients with sepsis by removing inflammatory factors in blood .关键词
连续性血液净化/脓毒症/凝血功能/细胞因子/CD4+/CD8+/APACHEⅡ评分/白介素/外周血T淋巴细胞Key words
Continuous blood purification/Sepsis/Coagulation function/Cytokine/CD4+/CD8+/APACHE Ⅱ score/Interleukin/Peripheral blood T lymphocytes分类
医药卫生引用本文复制引用
李军,张锋利,吐尔滚·艾沙,吴燕,李超..血液净化对脓毒症患者凝血功能及免疫功能的影响[J].中国免疫学杂志,2016,32(11):1661-1666,6.基金项目
本文为新疆医科大学第一附属医院2015年度院内科研基金项目（2015012）。 （）
