本文選題：膿毒性休克 + T淋巴細(xì)胞亞群�。� 參考：《中華全科醫(yī)學(xué)》2017年04期

【摘要】：目的探討在膿毒癥休克早期不同的液體復(fù)蘇方法對(duì)患者免疫功能、炎癥反應(yīng)及臟器功能的影響。方法選擇2012年11月—2015年11月溫州醫(yī)科大學(xué)附屬第二醫(yī)院ICU收治的成人膿毒癥休克患者180例,按數(shù)字隨機(jī)法分為脈搏指示連續(xù)心排出量(pulse indicator continuous cardiac output,PICCO)組94例和常規(guī)組86例,PICCO組患者在PICCO技術(shù)監(jiān)測(cè)下進(jìn)行精準(zhǔn)的液體復(fù)蘇,而常規(guī)組以常規(guī)方法進(jìn)行液體復(fù)蘇。對(duì)比分析2組患者在復(fù)蘇后臟器功能變化;ET-1、乳酸、白介素-10等炎癥因子的變化;T淋巴細(xì)胞等免疫功能變化,以及microRNA-155等分子生物學(xué)指標(biāo)的變化情況。結(jié)果 2組患者入院時(shí)的性別、年齡、急性生理學(xué)慢性健康狀況評(píng)分(APACHEⅡ)、平均動(dòng)脈壓、休克狀態(tài)差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),具有可比性。經(jīng)不同方法液體復(fù)蘇后,PICCO組患者的血壓波動(dòng)幅度、BNP、IL-10、ET-1水平低于常規(guī)組患者(P0.05),差異有統(tǒng)計(jì)學(xué)意義;PICCO組患者的microRNA-155、T細(xì)胞亞群高于常規(guī)組患者(P0.01)。結(jié)論 PICCO指導(dǎo)下的液體復(fù)蘇不但能使血壓平穩(wěn)恢復(fù),減輕心臟負(fù)荷,同時(shí)減輕炎癥介質(zhì),對(duì)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，

本文編號(hào)：2010399