| CBP治疗对重症脓毒症患者外周血单核细胞mCD14的影响 |
| 投稿时间：2017-10-22 修订日期：2017-11-10 点此下载全文 |
| 引用本文：李智鑫,应利君,金烈洲,吕铁,严一核.CBP治疗对重症脓毒症患者外周血单核细胞mCD14的影响[J].医学研究杂志,2018,47(8):91-95 |
| DOI：
10.11969/j.issn.1673-548X.2018.08.021 |
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| 基金项目:浙江省医药卫生科技计划项目（2015ZDA030） |
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| 中文摘要:目的 探讨连续性血液滤过技术（CBP）治疗对重症脓毒症患者外周血单核细胞mCD14的影响及其治疗脓毒症的机制。方法 将笔者医院重症医学科收治的60例重症脓毒症患者分为CBP组及非CBP组。在两组患者治疗过程的0、12、24、48、72h时相点，留取外周血标本，检测其mCD14及白细胞弹性蛋白酶表达量的变化。将治疗24h后的两组患者分离出外周血单核细胞，并于体外培养，以LPS刺激后，在4、8、12、24、48h时相点检测单核细胞中mCD14表达量的变化；同时用ELISA法检测单核细胞培养液中TNF-α、IL-6、IL-10水平。结果 随着治疗的进行，CBP组白细胞弹性蛋白酶水平较非CBP组下调更显著，差异具有统计学意义（P<0.05），而CBP组mCD14水平较非CBP组上调亦更显著，差异有统计学意义（P<0.05）；CBP组在孵育前及孵育后4、8h时相点mCD14水平明显高于同时相的脓毒症组，差异有统计学意义（P<0.05），其单核细胞接受LPS再刺激后对炎性反应能力也较脓毒症组强。结论 CBP治疗可通过高效清除循环中的炎性因子及白细胞弹性蛋白酶，使mCD14水平上调，使部分免疫细胞免疫功能得到一定的恢复，从而改善机体内环境，参与重建机体免疫内稳状态。 |
| 中文关键词:重症脓毒症 连续性血液滤过 mCD14 白细胞弹性蛋白酶 |
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| Effect of Continuous Hemofiltration on Peripheral Blood Monocyte Surface mCD14 in Patients with Traumatic Sepsis |
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| Abstract:Objective To investigate the effect of continuous hemofiltration (CBP) on peripheral blood mononuclear cells (mCD14) in sepsis patients and the mechanism of treatment of sepsis. Methods Sixty patients with severe post-traumatic sepsis were divided into CBP group and non-CBP group. In the two groups of patients during the treatment of 0, 12, 24, 48, 72h, leaving peripheral blood samples, and the changes of mCD14 and leukocyte elastase expression were detected. The peripheral blood mononuclear cells were isolated from the two groups after 24h of treatment and cultured in vitro. The changes of mCD14 expression in mononuclear cells were measured at 4, 8, 12, 24 and 48h after stimulation with LPS. The levels of TNF-α, IL-6 and IL-10 in mononuclear cells were detected by ELISA. Results The level of leukocyte elastase in CBP group was significantly lower than that in non-CBP group(P<0.05), and the level of mCD14 in CBP group was more significant than that in non-CBP group(P<0.05). The level of mCD14 in CBP group before and after incubation was significantly higher than that of sepsis group at 4,8h after incubation(P<0.05) and the ability of monocyte to respond to inflammation after LPS stimulation was also stronger than that of sepsis group. Conclusion CBP treatment can be achieved through efficient removal of circulating inflammatory factors and white blood cell elastase, mCD14 levels up, resulting in part of the immune cell immune function to be a certain recovery, thereby improving the body's environment involved in the reconstruction of the immune state of the state. |
| keywords:Traumatic sepsis Continuous hemofiltration mCD14 Leukocyte elastase |
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