连续性血液净化治疗多器官功能衰竭对Th1/Th2影响的临床研究

目的研究连续性血液净化治疗(CBP)对多器官功能衰竭患者循环Th1/Th2的影响.方法 36例多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)患者行CBP治疗.采用中心静脉留置单针双腔导管建立血管通路,采用Prisma连续性血液净化系统、以及配套的M60管路和滤器AN69(PAN膜,2.0 cm2)进行前稀释连续性静脉-静脉血液透析滤过(CVVHDF).治疗前及治疗后24,48,72 h采血检测Th1/Th2.结果 30例患者肾功能均恢复正常.在CBP治疗开始后24 h血Th1/Th2比值逐渐上升,48 h下降后有显著差异,72 h接近正常.24 h时与开始前比较,72 h与24h比较有非常显著性差异(P＜0.01).结论 CBP治疗可能可改善细胞免疫功能.

Effects of continuous blood purification on cell immune function in MODS patients

Objective To study the effects of continuous blood purification on Th1/Th2 in MODS patients.Methods A total of 36 patients with multiple organ dysfunction syndrome(MODS) were treated with continuous blood purification(CBP).The vascular access established with two-lumen indwelling catheter in venae profundae or internal arteriovenous fistula,and Prisma(Hospal)system for continuous venovenous hemodiaftltration(CVVHDF),the Gambro AN69 dialyzers with polyacrylonitrile(PAN) membrane were used.Th1/Th2 in plasma was checked before CBP and on 24 h,48 h,72 h after CBP.Twenty healthy subjects were employed as control.Results The renal function of 30 patients was recovered.The plasma Th1/Th2 was increased progressively in 24 h after CBP,reached nearly normal at 72 h.There was significant difference in plasma TH1/Th2 at 24 h after CBP as compared with that before CBP,at 72 h as compared with that at 24 h(P<0.01).Conclusion Continuous blood purification may improve cell immune function.