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1、匹酉醫(yī)藥2014年8月第49卷第8期JiangxiMedica1Jouma1.AUgust2014.V0149.No8·659··論著.低分子肝素對(duì)膿毒癥患者免疫功能的影響郭經(jīng)華,聶祥碧,楊春麗,王曾庚(江西省人民醫(yī)院重癥醫(yī)學(xué)科,南昌330006)摘要:目的評(píng)價(jià)低分子肝素對(duì)膿毒癥患者免疫功能及預(yù)后的影響。方法選取2013年1月至2013年6月人院的膿毒癥患者40例,分為低分子肝素組及對(duì)照組,于治療前及治療第3、7d使用流式細(xì)胞儀檢測(cè)膿毒癥患者使用低分子肝素前后T淋巴細(xì)胞亞群、NK細(xì)胞、B淋巴細(xì)胞的變化,同時(shí)統(tǒng)計(jì)患者APACHEⅡ評(píng)分、28d病死率、ICU住院時(shí)
2、間。比較兩組患者T淋巴細(xì)胞亞群、B淋巴細(xì)胞、NK細(xì)胞變化情況及與APACHEⅡ評(píng)分及28d病死率、ICU住院時(shí)間變化。結(jié)果兩組患者的T淋巴細(xì)胞亞群、B淋巴細(xì)胞、NK細(xì)胞隨積極治療后逐步升高,但兩組間比較無(wú)統(tǒng)計(jì)學(xué)差異(尸>0.05o組間比較APACHEⅡ評(píng)分無(wú)統(tǒng)計(jì)學(xué)差異(P>0.05),但低分子肝素組APACHEⅡ評(píng)分下降明顯優(yōu)于對(duì)照組,且低分子肝素組治療前后APACHEⅡ評(píng)分改變有統(tǒng)計(jì)學(xué)差異(P<0.05)。低分子肝素組患者住ICU時(shí)間、病死率均比對(duì)照組低,但兩組問(wèn)比較差異均無(wú)顯著性>0.05)。結(jié)論低分子肝素用于膿毒癥患者的治療能改善患者的APACHEⅡ評(píng)分
3、、28d病死率、ICU住院時(shí)間,但無(wú)統(tǒng)計(jì)學(xué)差異,對(duì)免疫功能的影響有待進(jìn)一步的研究。關(guān)鍵詞:膿毒癥;低分子肝素;T淋巴細(xì)胞亞群;B淋巴細(xì)胞中圖分類(lèi)號(hào):R459.7文獻(xiàn)標(biāo)識(shí)碼:A文章編號(hào):1006—2238(2014)08—659—03DOI:10.3969~.issn.1006—2238.2014.08.001EfectoflowmolecularheparinonimmunefunctionofpatientswithsepsisGUOJinghua,NIEXiangbi,YANGChunli,eta1.DepartmentofCriticalCareMedi
4、cine,People’HospitalofJiangxiProvince,Nanchang,JiangxiProvince330006.Abstract:ObjectiveToevaluatetheeffectoflowmolecularheparin.ofimmunefunctionandprognosisofpatientswithsep.sis.Method40hospitalizedpatientswithsepsisfromJan2013toJune2013,weredividedintolowmolecularheparingroupandcon
5、trolgroup,beforetreatmentandatthirdandseventhdayusingflowcytometrytotestthechangeofTlymphocytesubsets,NKcells,Blymphocytesbeforeandafterusinglowmolecularweightheparinofpatientswithsepsis.a(chǎn)ndatthesametimemakestatis—ticswhichwereAPACHE11score,28dmortalityandlengthoftimeintheICU.Tocomp
6、aretwogrouppatients’changeofTlym—phocytesubsets,BlymphocytesandNKcells,andthechangeofAPACHEIIscoreand28dmortality,lengthofhospitalizedtimeintheICU.ResultsTlymphocytesubsets,Blymphocytes,NKcellsoftwogroupspatientswithactivetreatmentweregraduallyincreased,butthetwogroupshadnostatistic
7、aldifference(P>0.o5).ComparisonbetweengroupsofAPACHEIIscorewerenosig—nificantdifference0.05),butthelowmolecularheparingroupAPACHEIIscorewerelowerthanthatofthecontrolgroup,andthechangeofAPACHEIIscoreoflowmolecularheparingroupbeforeandaftertreatmentwasstatisticallysignificantdiference
8、(P<0.05).Lengthofho