【摘要】 目的:探讨血浆灌流(PP)治疗对肝衰竭患者循环血中T淋巴细胞亚群及炎性因子水平表达的影响及临床意义。方法:以112例肝衰竭患者作为治疗组,选取同期HBsAg(-)的健康体检者25例为对照组,检测在PP治疗前后循环血中CD4~+T、CD8~+T及炎性因子中的肿瘤坏死因子-α(TNF-α)、白细胞介素-6 (IL-6)、IL-10、γ-干扰素(IFN-γ)的水平表达。结果:治疗组患者在采用PP治疗后,TBIL、ALT、PTA、CRP的表达水平较治疗前明显下降(P<0.05)。治疗组患者采用PP治疗前,CD4~+T、CD8~+T水平较对照组低表达,CD4~+T/CD8~+T比值高表达,差异有统计学意义(P<0.05)。治疗组患者在PP治疗后,CD4~+T、CD8~+T水平较治疗前明显上调,CD4~+T/CD8~+T比值明显下调,差异有统计学意义(P<0.05); CD4~+T、CD8~+T水平较对照组明显下调,CD4~+T/CD8~+T比值明显上调,差异有统计学意义(P<0.05)。治疗组患者在PP治疗前,TNF-α、IFN-γ、IL-6、IL-10水平较对照组明显上调,差异有统计学意义(P<0.05);治疗组患者在PP治疗后TNF-α、IFN-γ、IL-6、IL-10水平较治疗前明显下调,差异有统计学意义(P<0.05);治疗组患者在PP治疗后TNF-α、IFN-γ、IL-6、IL-10水平较对照组明显上调,差异有统计学意义(P<0.05)。结论:PP治疗肝衰竭患者可显著调控循环血中T淋巴细胞亚群的失衡状态,调节紊乱的炎性因子水平,促进肝功能复常,提高肝衰竭患者存活率。更多还原

【Abstract】 Objective:To investigate the effect of Plasma perfusion(PP) on the levels of T lymphocyte subgroup and inflammatory factors in circulating blood of patients with hepatic failure and its clinical significance.Methods:112 patients with liver failure were selected as the treatment group,and 25 healthy persons with HBsAg(-) in the same period were selected as the control group.The levels of CD4~+T,CD8~+T and tumor necrosis factor(TNF-α),interleukin-6(IL-6),interleukin-10(IL-10),ifn-interferon(IFN-γ) in circulating blood before and after PP treatment were detected.Results:The expression levels of TBIL,ALT,PTA and CRP were significantly decreased in the treatment group after PP treatment compared with that before treatment(P<0.05).The CD4~+T and CD8~+T levels in the treatment group were lower than those in the control group before PP treatment,and the CD4~+T/CD8~+T ratio was higher,with statistically significant differences(P<0.05).In the treatment group,CD4~+T and CD8~+T levels were significantly up-regulated after PP treatment,and CD4~+T/CD8~+T ratio was significantly down-regulated,with statistically significant differences(P<0.05).After PP treatment,CD4~+T and CD8~+T levels in patients in the treatment group were significantly lower than those in the control group,and the CD4~+T/CD8~+T ratio was significantly up-regulated,with statistically significant differences(P<0.05).The levels of TNF-α,IFN-γ,IL-6 and IL-10 in the treatment group were significantly higher than those in the control group(P<0.05),the levels of TNF-α,IFN-γ,IL-6 and IL-10 in the treatment group were significantly lower than those in the control group(P<0.05),the levels of TNF-α,IFN-γ,IL-6 and IL-10 in the treatment group were significantly higher than those in the control group(P<0.05),the difference was statistically significant(P<0.05).Conclusion:PP treatment for liver failure patients can significantly regulate the imbalance of T lymphocyte subsets in circulating blood,regulate the level of disordered inflammatory factors,promote the recovery of liver function,and improve the survival rate of liver failure patients.更多还原