摘要
Abstract
Objective To investigate the changes in CD8+T lymphocyte count and effect on immune function in patients with sepsis after continuous renal replacement therapy (CRRT).Methods General data of septic patients who admitted to the emergency department of a hospital between October 2015 and August 2016 were collected,pe-ripheral blood was taken from patients before and after single CRRT,the total CD8+T cell count,interferon-γ(IFN-γ)-secreting CD8+T cell count,the levels of inhibitory molecules and costimulatory molecules as well as IFN-γand tumor necrosis factor-α(TNF-α)produced by CD8+T cells were detected.Results A total of 37 hospitalized septic patients were infected with gram-negative bacteria, pathogens causing infection were Klebsiella pneumoniae (22 strains),Acinetobacter baumannii (1 1 strains),and Enterobacter cloacae (3 strains).After CRRT,the body temperature,heart rate,white blood cell count,urea nitrogen,and serum creatinine levels in septic patients were all lower than those before CRRT (all P<0.05).After CRRT,the total CD8+T cell count in septic patients didn’t change significantly (P>0.05),but IFN-γ-secreting CD8+T cell count increased (P<0.05).Levels of cytotoxic T lymphocyte-associated antigen 4(CTLA-4),programmed death-1 (PD-1),T-cell immunoglobulin and mucin-do-main-containing molecule 3 (TIM-3)after CRRT were all lower than those before CRRT (all P<0.05 ),while levels of costimulatory molecules CD28 and secreting IFN-γ elevated after CRRT(all P<0.05).Conclusion CRRT can not only improve the vital signs and renal function of patients with sepsis,but also enhance the immune function of CD8+T cells.关键词
脓毒症/连续性肾脏替代治疗/CD8+T淋巴细胞/免疫调节Key words
sepsis/continuous renal replacement therapy/CD8+T lymphocyte/immunoregulation分类
医药卫生