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目的:观察联合应用血液灌流与血液透析治疗对重症急性胰腺炎(SAP)患者CD8+CD28-T细胞水平及全身炎症状态的影响。方法:选择2013年2月—9月收治的确诊为SAP的患者52例,随机均分为观察组和对照组。对照组接受常规治疗,观察组在常规治疗的基础上加用血液灌流联合血液透析治疗。比较两组治疗24 h后血清中CD8+CD28-T细胞、炎症因子、淀粉酶水平,以及两组临床症状恢复情况。结果:两组患者在治疗前的各项实验室指标差异均无统计学意义(均P>0.05);治疗24 h后,两组患者血清中CD8+CD28-T细胞水平、抑炎因子水平均明显升高,而促炎因子及淀粉酶水平均明显降低,但观察组所有指标的改善程度均优于对照组(均P<0.05);观察组临床症状恢复时间、胃肠功能恢复时间、住院时间均明显短于对照组(均P<0.05),两组体温恢复时间差异无统计学意义(P>0.05)。结论:联合应用血液灌流与血液透析治疗可有效提高SAP患者CD8+CD28-T细胞水平抑制全身炎症反应,加快病情恢复。
Objective: To observe the effect of combined application of hemoperfusion and hemodialysis on the level of CD8 + CD28-T cells and systemic inflammatory status in patients with severe acute pancreatitis (SAP). Methods: 52 patients diagnosed as SAP from February to September in 2013 were randomly divided into observation group and control group. The control group received routine treatment, the observation group on the basis of conventional treatment plus hemoperfusion plus hemodialysis treatment. Serum levels of CD8 + CD28-T cells, inflammatory cytokines and amylase were compared between the two groups after treatment for 24 h, and the clinical symptoms were recovered. Results: There was no significant difference between the two groups in each laboratory before treatment (all P> 0.05). After 24 hours treatment, the levels of CD8 + CD28-T cells and anti-inflammatory cytokines (P <0.05). The recovery time of clinical symptoms, the recovery time of gastrointestinal function, the hospitalization of patients in the observation group were significantly higher than those in the control group Time were significantly shorter than the control group (all P <0.05), there was no significant difference between the two groups in the recovery time of body temperature (P> 0.05). Conclusion: The combined application of hemoperfusion and hemodialysis can effectively increase the level of CD8 + CD28-T cells in SAP patients and inhibit the systemic inflammatory response and accelerate the recovery of the disease.