湖南师范大学学报（医学版）
湖南師範大學學報（醫學版）
호남사범대학학보（의학판）
JOURNAL OF HUNAN NORMAL UNIVERSITY(MEDICAL SCIENCE)
2013年
2期
71-73,89
,共4页
脓毒症%T淋巴细胞亚群
膿毒癥%T淋巴細胞亞群
농독증%T림파세포아군
sepsis%lymphocyte subsets
目的：评价检测脓毒症患者免疫指标变化对其预后的预测作用。方法：选取2012年1月至2012年12月在本院ICU住院治疗的90例脓毒症患者，于入院时及治疗第4天抽取静脉血分析T淋巴细胞亚群CD3、CD4、CD8、CD4/CD8及HLA-DR比例情况。同时对患者自入院起，进行APACHEⅡ评分及SOFA评分。根据患者最终转归分为存活组及死亡组。比较两组患者T淋巴细胞亚群变化情况及与APACHEⅡ评分及SOFA评分的相关性。结果：脓毒症存活组APACHEⅡ评分及SOFA评分较死亡组低，且随着治疗有明显下降趋势。而死亡组APACHEⅡ评分及SOFA评分一直处于较高水平，并没有随着治疗开展而下降。入院时，脓毒症存活组及死亡组CD4/CD8及HLA-DR均低于正常范围，经治疗后，存活组CD3、CD4、CD4/CD8及HLA-DR比例均出现上升，达到正常范围，而死亡组D4，CD3，CD4，CD4/CD8及HLA-DR比例均出现明显下降，低于正常水平，且明显低于存活组。T淋巴细胞亚群比例与APACHEⅡ评分及SOFA评分呈负相关。结论：T淋巴细胞亚群CD3、CD4、CD8、CD4/CD8及HLA-DR比例变化情况对脓毒症患者预后有较好预测价值，持续降低提示患者预后不良。
目的：評價檢測膿毒癥患者免疫指標變化對其預後的預測作用。方法：選取2012年1月至2012年12月在本院ICU住院治療的90例膿毒癥患者，于入院時及治療第4天抽取靜脈血分析T淋巴細胞亞群CD3、CD4、CD8、CD4/CD8及HLA-DR比例情況。同時對患者自入院起，進行APACHEⅡ評分及SOFA評分。根據患者最終轉歸分為存活組及死亡組。比較兩組患者T淋巴細胞亞群變化情況及與APACHEⅡ評分及SOFA評分的相關性。結果：膿毒癥存活組APACHEⅡ評分及SOFA評分較死亡組低，且隨著治療有明顯下降趨勢。而死亡組APACHEⅡ評分及SOFA評分一直處于較高水平，併沒有隨著治療開展而下降。入院時，膿毒癥存活組及死亡組CD4/CD8及HLA-DR均低于正常範圍，經治療後，存活組CD3、CD4、CD4/CD8及HLA-DR比例均齣現上升，達到正常範圍，而死亡組D4，CD3，CD4，CD4/CD8及HLA-DR比例均齣現明顯下降，低于正常水平，且明顯低于存活組。T淋巴細胞亞群比例與APACHEⅡ評分及SOFA評分呈負相關。結論：T淋巴細胞亞群CD3、CD4、CD8、CD4/CD8及HLA-DR比例變化情況對膿毒癥患者預後有較好預測價值，持續降低提示患者預後不良。
목적：평개검측농독증환자면역지표변화대기예후적예측작용。방법：선취2012년1월지2012년12월재본원ICU주원치료적90례농독증환자，우입원시급치료제4천추취정맥혈분석T림파세포아군CD3、CD4、CD8、CD4/CD8급HLA-DR비례정황。동시대환자자입원기，진행APACHEⅡ평분급SOFA평분。근거환자최종전귀분위존활조급사망조。비교량조환자T림파세포아군변화정황급여APACHEⅡ평분급SOFA평분적상관성。결과：농독증존활조APACHEⅡ평분급SOFA평분교사망조저，차수착치료유명현하강추세。이사망조APACHEⅡ평분급SOFA평분일직처우교고수평，병몰유수착치료개전이하강。입원시，농독증존활조급사망조CD4/CD8급HLA-DR균저우정상범위，경치료후，존활조CD3、CD4、CD4/CD8급HLA-DR비례균출현상승，체도정상범위，이사망조D4，CD3，CD4，CD4/CD8급HLA-DR비례균출현명현하강，저우정상수평，차명현저우존활조。T림파세포아군비례여APACHEⅡ평분급SOFA평분정부상관。결론：T림파세포아군CD3、CD4、CD8、CD4/CD8급HLA-DR비례변화정황대농독증환자예후유교호예측개치，지속강저제시환자예후불량。
Objective To analyze the immunity fuction change (peripheral blood lymphocyte subsets) and prognosis prospective value in patients with sepsis. Methods A total of 90 patients with sepsis from Jan.2012 to Dec. 2012 were included into the study.T lymphocyte subgroups (CD 3,CD4,CD4/CD8,HLA-DR)was analyzed in all patients in first and fourth day.The APACHE on the patient Ⅱgrading and SOFA grading was analyzed. The patients were divided into survival group and the death group.The T lymphocyte subgroup and APACHE on the patientⅡgrading and SOFA grading were analysis in the two groups. Results The APACHE grading and SOFA grading in the death group was higher than the survival group. The APACHE grading and SOFA grading in the death group had no changes after the treatment.But the grading in the survival group was reduced. The ratios CD3,CD4, CD4+/CD8+and HLA-DR in death group showed difference from the survival group after treatment.It was significant lower than survival. Conclusion The T lymphocyte subsets monitor has good prospective value to the patients with sepsis.
