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1、重度脓毒症患者的免疫增强治疗临床研究［摘要］目的：分析重度脓毒症患者的细胞免疫状态，并研究«1胸腺肽对免疫调节治疗的影响。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白细胞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/U1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a1胸腺肽1.6mg/d,连续7d,同时给予经典SSC治疗；对照纟R给予经典S
2、SC治疗。观察患者治疗前及治疗后3、7d±述免疫指标。结果:85例重度脓毒症患者HLA-DR、CD3+、CD4+和CD8+T淋巴细胞明显降低，治疗组治疗后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)
3、,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下患者单核细胞CD14+HLA-DR和T淋巴细胞计数短期内均呈上升趋势，重度免疫低下患者仅治疗后7dCD3+较治疗前增高(P〈0.05)。结论：重度脓毒症患者存在细胞免疫抑制；al胸腺肽具有免疫增强的作用，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；a1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)-054-04Clini
4、calstudyoftheimmunopotentiationtherapyinthepatientswithseveresepsisZHOUQin,GUOGuangyunDepartmentofRespiratory,ThePeople'sHospitalAffiliatedtoHubeiUniversityofMedicine,HubeiProvince,Shivan442000,China［Abstract］Objective:Toexplorethecellularimmunitystat
5、einthepatientswithseveresepsisandinfluencesofimmune-modu1ationtherapywithThymosina1.Methods:135patientswithseveresepsisinourhospitalfromFebruary2010toFebruary2011wereenrolled・ThetrendsofserumCD14+monocyteHLA-DRlevels,theabsolutecountingofTlymphocytess
6、ubpopulationweremonitorcd・AndthepatientswithseveresepsiswererandomlydividedintotwogroupsbytheabsolutecountingofCD4+T1ymphocytessubpopulation<410cells/u1>ThepatientsincontrolgroupweretreatedwithclassicalSSCtherapy,thoseintreatmentgroupweretreatedwithTh
7、ymosina1,1.6mgsubcutaneousinjectionperday,continued7daysandclassicalSSCtherapy.Levelsofaboveimmuncindexesweredetectedbeforetreatmentandafter3davsand7davsoftreatment.Results:LevelsofserumHLA-DR,CD3+,CD4+,CD8+Tlymphocyteweresignificantlydecreasedin85pat
8、ientswithseveresepsis.LevelsofserumIILA-DR,CD3+,CD4+,CD8+Tlymphocytewereincreasedsignificantlyafter7daystreatmentintreatmentgroup・Theseparameterswerehigherafter7daysthanafter3days(P<0.05orP〈0・01)・Comparedwiththevariablesatthesameperiodinthecon
