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1、巫度脓毒症患者的免疫增强治疗临床研究［摘耍］冃的：分析重度脓售症患者的细胞免疫状态，并研究a1胸腺肽对免疫调节治疗的彫响。方法：选取2010年2月~2011年2月我院重度脓毒症患者135例，监测血清单核细胞人口细胞DR抗原(HLA-DR)、T淋巴细胞亚群绝对计数的动态变化；研究取CD4+T淋巴细胞绝对计数<410cells/y1的患者，并分为治疗组和对照组，治疗组再按CD4+T淋巴细胞绝对计数进行亚组分析。治疗组皮下注射(】1胸腺肽1.6mg/d,连续7d,同时给予经典SSC治疗；对照组给予经典SSC治疗。观察患者治疗前及治疗后3、7d±述免疫指标。结果:85例重度
2、脓毒症患者HLA-DR.CD3+、CD4+和CD8+T淋巴细胞明显降低，治疗纟fl治疗示7dHLA-DR、CD3+、CD4+和CD8+均明显增高,且7dHLA-DR、CD3+、和CD8+较3dHLA-DR>CD3+和CD8+增高,差异有统计学意义(P〈0.05或P<0.01)。与对照组同期比较,治疗组治疗后3dCD3+、7dHLA-DR、CD4+和CD8+均增高,7dCD3+则明显升高,差异有统计学意义(P<0.05或P<0.01),而CD4+/CD8+比值无明显变化。治疗组亚组分析显示轻屮度免疫低F患者单核细胞CD14+HLA-DR和T淋巴细胞计数短期内均呈上升趋
3、势，重度免疫低下患者仅治疗后7dCD3+较治疗前增高(P<0.05)o结论：重度脓毒症患者存在细胞免疫抑制；al胸腺肽具冇免疫增强的作用，且对轻中度免疫低下效果更好，重度免疫低下持续治疗也能获益。［关键词］重度脓毒症；«1胸腺肽；细胞免疫；随机对照试验［中图分类号］R631［文献标识码］A［文章编号］1673-7210(2011)11(a)-054-04ClinicalstudyoftheiinmunopotentiationtherapyinthepatientswithseveresepsisZHOUQin,GUOGuangyunDepartmentofResp
4、iratory,ThePeople'sHospitalAffiliatedtoHubeiUniversityofMedicine,HubeiProvince,Shiyan442000,China［Abstract］Objective:Toexplorethecellularimmunitystateinthepatientswithseveresepsisandinfluencesofimmune-modulationtherapywithThymosinu1.Methods:135patientswithseveresepsisinourhospitalfromF
5、ebruary2010toFebruary2011wereenrolled.ThetrendsofserumCD14+monocyteHLA-DRlevels,theabsolutecountingofTlymphocytessubpopulationweremonitored・AndthepatiemswithseveresepsiswererandomlydividedintotwogroupsbytheabsolutecountingofCD4+TlymphocytessubpopulationV410cel1s/u1.Thepatientsincontrol
6、groupweretreatedwithclassicalSSCtherapy,thoseintreatmentgroupweretreatedwithThymosina1,L6mgsubcutaneousinjectionperday,continued7daysandclassicalSSCthorapy.Levelsofaboveimmunoindexosweredetectedbeforetreatmentandafter3daysand7daysoftreatment.Results:LevelsofserumHLA-DR,CD3+,CD4+,CD8+Tl
7、ymphocyteweresignificantlydecreasedin85patientswithseveresepsis.LevelsofserumHLA-DR,CD3+,CD4+,CD8+Tlymphocytewereincreasedsignifiedntlyafter7daystreatmentintreatmentgroup・Theseparameterswerehigherafter7daysthanafter3days(P<0.05orP<0・01)・Comparedwiththevariablesatthesameperiodinthecon
