早期连续肾脏替代治疗对急性重症胰腺炎患者外周血CD4+CD25+调节性T细胞的影响

摘要

Objective To study the effect of continuous renal replacement therapy ( CRRT ) on CD4+CD25+ regulatory T cells( Treg) in patients with severe acute pancreatitis. Methods 23 patients enrolled in the study were divided into CRRT treated group ( n=12 ) and control group ( n=11 ) . The serum sample were collected and measured leukocyte count (WBC), C reactive protein(CRP), procalcitonin (PCT) to reflect the gradient of infection. Meanwhile, we collected the characteristics for APACHE II scores. The lev_els of CD4+CD25+ Treg were performed by flow cytometry (FCM) on admission and days 1, 3, 5, 7. Re―sults The general information shows no significant different between two groups. There is a declining trend of CD4+CD25+ Treg in peripheral blood in CRRT treated group, and shows significant decline on days 5, 7 as compared to control group(8. 11±1. 97 VS 9. 71±1. 52, t =2. 125, P =0. 046;6. 70±2. 62 VS 9. 10±1. 48, t =2 . 594 , P =0 . 017 ) . Conclusion CRRT could command CD4+CD25+Treg in patients with sepsis-associ_ated ARDS, and regulate immune function.%目的：研究连续肾脏替代治疗( CRRT)对急性重症胰腺炎( SAP)患者外周血CD4+CD25+调节性T细胞(Treg)的影响。方法23例SAP患者随机分为CRRT治疗组(n=12)和对照组(n=11)。采集患者入选研究后的外周血行白细胞计数( WBC)、C反应蛋白( CRP)、降钙素原( PCT)检测来反映患者的感染程度,同时记录急性生理和慢性健康( APACHE II)评分反应患者病情的严重程度,流式细胞术( FCM)检测各组入选时、1、3、5、7 d的外周血CD4+CD25+ Treg的水平。结果两组间的一般资料比较差异无统计学意义(P>0.05)。 CRRT治疗组的CD4+CD25+Treg含量在第5、7d与对照组比较差异有统计学意义(8.11±1.97 VS 9.71±1.52,t=2.125,P=0.046；6.70±2.62 VS 9.10±1.48,t=2.594,P=0.017)。结论早期CRRT能改善SAP患者Treg过多的现象,起到调节免疫紊乱的功能。