延长每日血液滤过对全身炎症反应综合征或脓毒血症合并急性肾损伤患者外周血T细胞亚群的影响

目的比较延长每日血液滤过（EDHF）对全身炎症反应综合征（SIRS）或脓毒血症合并急性肾损伤（AKI）患者外周血T细胞亚群以及患者预后的影响。方法前瞻性收集2009年1月至2013年6月在我院急诊及重症监护病房住院的SIRS合并AKI的患者40例,根据有无感染分为SIRS组和脓毒血症组,在常规治疗基础上,予以EDHF治疗,比较两组患者外周血T细胞亚群及患者死亡率、肾存活率。结果两组患者死亡率差异显著（P〈0.05）。治疗3 d后,与脓毒血症组比较SIRS组CD8＋值降低（P〈0.01）,但CD4＋/CD8＋比值高（P〈0.05）。结论 SIRS合并AKI的患者经EDHF治疗存活率高于脓毒血症合并AKI者,前者的细胞免疫功能改善显著。

Effect of extented daily hemofiltration on T cell subpopulations for the acute kidney injury patients with SIRS or sepsis

Objecitve To observe the effect of extended daily hemofiltration（EDHF） on T cell subpopulations in patients of systemic inflammatory response syndrome（SIRS） or sepsis combined with acute kidney injury（AKI）. Methods Totally 40 cases of SIRS/sepsis with AKI were collected prospectively between 2009 Jan and 2013 Jun. Those patients were devided into SIRS and sepsis group based on the indication of infection. All patients were given EDHF based on the conventional therapy. The progression of disease（including mortality rate in hospital, kidney survival rate） and T cell subpopulation status in two groups were measured and compared. Results A significant difference in mortality rate between two groups（P0.05）. Compared with sepsis group, the value of CD8＋was lower, and the CD4＋/CD8＋levels increased in SIRS group（P0.05）.Conclusion For SIRS/sepsis patients with AKI after EDHF, the survival rate of the SIRS group is higher than that in sepsis group, and the cell-immune function of SIRS group has been improved.