PICCO指导下液体复苏对脓毒症休克患者免疫功能及炎症介质的影响

发布时间：2018-06-12 17:02

  本文选题：脓毒性休克 + T淋巴细胞亚群　； 参考：《中华全科医学》2017年04期

【摘要】：目的探讨在脓毒症休克早期不同的液体复苏方法对患者免疫功能、炎症反应及脏器功能的影响。方法选择2012年11月—2015年11月温州医科大学附属第二医院ICU收治的成人脓毒症休克患者180例,按数字随机法分为脉搏指示连续心排出量(pulse indicator continuous cardiac output,PICCO)组94例和常规组86例,PICCO组患者在PICCO技术监测下进行精准的液体复苏,而常规组以常规方法进行液体复苏。对比分析2组患者在复苏后脏器功能变化;ET-1、乳酸、白介素-10等炎症因子的变化;T淋巴细胞等免疫功能变化,以及microRNA-155等分子生物学指标的变化情况。结果 2组患者入院时的性别、年龄、急性生理学慢性健康状况评分(APACHEⅡ)、平均动脉压、休克状态差异均无统计学意义(P0.05),具有可比性。经不同方法液体复苏后,PICCO组患者的血压波动幅度、BNP、IL-10、ET-1水平低于常规组患者(P0.05),差异有统计学意义;PICCO组患者的microRNA-155、T细胞亚群高于常规组患者(P0.01)。结论 PICCO指导下的液体复苏不但能使血压平稳恢复,减轻心脏负荷,同时减轻炎症介质,对提高免疫功能具有一定的作用。
[Abstract]:Objective to investigate the effects of different fluid resuscitation methods on immune function, inflammatory response and organ function in patients with septic shock. Methods 180 adult septic shock patients treated in ICU of the second affiliated Hospital of Wenzhou Medical University from November 2012 to November 2015 were selected. According to digital random method, 94 patients in pulse indicator continuous cardiac output PICCO group and 86 patients in routine group underwent accurate fluid resuscitation under PICCO monitoring, while conventional group performed fluid resuscitation with routine method. The changes of organ function such as ET-1, lactic acid, interleukin-10 and immune function of T lymphocytes and microRNA-155 were compared between the two groups after resuscitation. Results there were no significant differences in gender, age, acute physiological chronic health status score (Apache 鈪，

本文编号：2010399