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[摘要]
目的 分析小剂量甲泼尼龙对脓毒血症患者疗效及对免疫细胞的影响。方法 回顾性分析2014年10月-2016年10月到普陀区利群医院诊治的脓毒血症患者共72例,每组36例,对照组患者给予常规抗感染治疗,观察组患者在此基础上配合小剂量甲泼尼龙治疗,均连续治疗7 d,比较两组患者疗效和治疗前后免疫细胞、炎症因子水平。结果 观察组患者生存率为80.56%,明显高于对照组的55.56%,差异有统计学意义(P<0.05),并发症发生率未表现出明显差异。治疗前两组患者免疫细胞水平未表现出明显差异,治疗后观察组CD4+ T淋巴细胞、CD8+ T淋巴细胞均明显高于对照组,CD4+/CD8+明显低于对照组,组间差异有统计学意义(P<0.05);治疗后观察组血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)、白细胞介素-1(IL-1)等炎症因子水平均明显低于对照组,差异有统计学意义(P<0.05)。结论 小剂量甲泼尼龙用于脓毒血症患者疗效确切,能够有效调节T淋巴细胞和炎症因子水平,降低机体免疫反应,提高生存率,推荐临床推广应用。
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[Abstract]
Objective To investigate the effect of small dosage of methylprednisolone in treatment of sepsis and the influence on immune cells. Methods Totally 72 patients diagnosed with sepsis in Liqun Hospital from October 2014 to October 2016 were selected in this research. They were randomly divided into two groups:36 patients in control group received conventional anti-infective treatment, and 36 patients in observation group were treated with small dosage of methylprednisolone on the basis of control group. The efficacy and level of immune cells were compared in two groups. Results The survival rate in observation group was significantly higher than that of control group (P<0.05). The difference of the incidence of complications and the level of immune cells before treatment between two groups had not statistical significance. CD4+ T lymphocytes and CD8+ T lymphocytes in observation group were significantly higher than those of control group after treatment, whereas the ratio of CD4+/CD8+ and levels of CRP, TNF-α, PCT and IL-1 were lower than those of control group (P<0.05). Conclusion There is a significant effect of small dosage of methylprednisolone in treatment of sepsis, which can regulate apoptosis of T lymphocyte and inflammatory factor, reduce the immune response, improve the survival rate, and recommend the clinical popularization and application.
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