Yuan Yuan-Hong, Yuan Yuan-Hong, Xiao Zheng-Hui, Zhang Hui, Fan Jiang-Hua, Zhang Xin-Ping, Lu Xiu-Lan, Xu Zhi-Yue, Luo Hai-Yan
Intensive Care Unit, Hunan Province Children's Hospital, Changsha 410007, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2014 Feb;16(2):194-7.
To investigate the impact of continuous blood purification (CBP) on T-cell subsets and prognosis in children with severe sepsis.
A total of 42 children with severe sepsis were randomly divided into a control group (n=22) and a CBP group (n=20). The patients in the control group received conventional treatment, while those in the CBP group underwent continuous veno-venous hemofiltration daily 12-24 hours for 3 days besides conventional treatment. Changes in clinical variables and in peripheral blood regulatory T cell subsets were assessed 3 and 7 days after treatment.
The pediatric intensive care unit length of stay and duration of mechanical ventilation were significantly shortened and the 28-day mortality rate was significantly lower in the CPB treatment group as compared with the control group (P<0.05). In the CBP treatment group, the percentage of CD3(+), CD4(+), CD8(+) T cell populations and PCIS scores were significantly higher at 3 and 7 days after treatment than before treatment (P<0.05). At 7 days after treatment, the percentage of CD3(+), CD4(+), CD8(+) T cell populations, CD4(+)/CD8(+) ratio and PCIS scores were significantly higher in the CBP group than in the control group (P<0.05).
The CBP treatment may counteract the suppression of immune function and thus improve prognosis in children with severe sepsis.
探讨持续血液净化（CBP）对重症脓毒症患儿T细胞亚群及预后的影响。
将42例重症脓毒症患儿随机分为对照组（n = 22）和CBP组（n = 20）。对照组患儿接受常规治疗，而CBP组患儿除常规治疗外，每天进行12 - 24小时的持续静静脉血液滤过，共3天。在治疗后3天和7天评估临床变量及外周血调节性T细胞亚群的变化。
与对照组相比，CBP治疗组患儿在儿科重症监护病房的住院时间和机械通气时间显著缩短，28天死亡率显著降低（P < 0.05）。在CBP治疗组中，治疗后3天和7天CD3(+)、CD4(+)、CD8(+) T细胞群体百分比及PCIS评分均显著高于治疗前（P < 0.05）。治疗后7天，CBP组CD3(+)、CD4(+)、CD8(+) T细胞群体百分比、CD4(+)/CD8(+)比值及PCIS评分均显著高于对照组（P < 0.05）。
CBP治疗可能抵消免疫功能的抑制，从而改善重症脓毒症患儿的预后。
