摘要
目的探讨脓毒症患者免疫功能动态变化与中医证型及预后的相关性。方法选择脓毒症患者52例,按卫气营血辨证分组,同时纳入健康对照组10例,采集脓毒症患者诊断第1天、第7天血液行流式细胞学检测,包括CD4+、CD8+、CD4+/CD8+、CD14+/HLA-DR+。结果与健康对照组比较,脓毒症所有指标水平降低(P<0.05);脓毒症按卫气营血辨证分为气分组、营分组、血分组,由气分至血分,CD4+/CD8+、CD14+/HLA-DR+呈下降趋势,CD8+呈上升趋势(P<0.05),CD4+水平差异无统计学意义(P>0.05);脓毒症死亡组与存活组比较,死亡组两次检测CD4+/CD8+、CD14+/HLA-DR+低于存活组(P<0.05);二元logistics回归分析,卫气营血辨证分型、CD8+T细胞占比与28 d死亡率呈正相关,其余免疫指标与28 d死亡呈负相关。结论脓毒症患者早期即存在明显免疫功能下降,不同卫气营血辨证分型组及死亡组与存活组患者之间,免疫功能存在显著差异。
Objective:To investigate the correlation between the dynamic changes of immune function and TCM syndromes and prognosis in patients with sepsis.Methods:52 patients with sepsis were selected and grouped according to the syndrome differentiation of Weiqiyingxue.At the same time,10 healthy controls were included.The blood of patients with sepsis was collected on the 1 st and 7 th day of diagnosis for flow cytometry,including CD8+,CD4+/CD8+,CD14+/HLA-DR+.Results:Compared with the healthy control group,the levels of all indexes of sepsis decreased(P<0.05),sepsis was divided into Qi group,Ying group,and Xue group.From Qi to Xue,CD4+/CD8+,CD14+/HLA-DR+showed a down ward trend,CD8+showed an upward trend(P<0.05),and the difference in CD4+levels was not statistically significant(P>0.05).Comparing the sepsis death group with the survival group,the two detections of CD4+/CD8+and CD14+/HLA-DR+in the death group were lower than those in the survival group(P<0.05),binary logistics regression analysis,the dialectical classification of Weiqiyingxue,the proportion of CD8+T cells were positively correlated with 28 day death,and the remaining immune indicators were negatively correlated with 28 day death.Conclusion:Patients with sepsis have significant immune function decline in the early stage.There are significant differences in immune function between patients with different Weiqiyingxue syndrome differentiation groups and the dead and surviving groups.
作者
余勰
张贵方
陈雪梅
何艳萍
Yu Xie;Zhang Guifang;Chen Xuemei;He Yanping(Chongqing Hospital of Traditional Chinese Medicine,Chongqing 400021,China)
出处
《中国中医急症》
2021年第12期2123-2125,2129,共4页
Journal of Emergency in Traditional Chinese Medicine
基金
重庆市科委绩效激励引导专项(cstc2018jxjl130075,jxyn2020-5)
重庆市卫生计生委中医药科技项目(ZY201802065)
成都中医药大学“杏林学者”学科人才科研提升计划项目(YYZX20180039,YYZX2019073)。
关键词
脓毒血症
免疫功能
卫气营血辨证
预后
Sepsis
Immune function
Syndrome differentiation of Weiqiyingxue
Prognosis
