The effects of glucocorticoid and continuous blood purification on cellular immune function and prognosis in children with severe sepsis/septic shock
10.3760/cma.j.issn.1673-4912.2018.11.003
- VernacularTitle:糖皮质激素和连续血液净化对严重脓毒症患儿细胞免疫功能的影响
- Author:
Jinlong LIU
1
;
Haiqing WANG
;
Yujuan WANG
;
Wei WANG
;
Yi YIN
;
Youpeng JIN
Author Information
1. 山东大学附属省立医院小儿重症医学科
- Keywords:
Severe sepsis;
Children;
Glucocorticoid;
Blood purification;
Immune function
- From:
Chinese Pediatric Emergency Medicine
2018;25(11):813-818
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effects of glucocorticoid and blood purification on cellular immune function and prognosis in children with severe sepsis/septic shock. Methods Fifty-five pediatric patients with severe sepsis/septic shock admitted to PICU of Shandong Provincial Hospital between January 2015 and June 2017 were enrolled in the study and were divided into control group,hormone group and con-tinuous blood purification group according to treatment. PCIS,PICU stay,immune function,3\7\28-day mor-tality rate,the level of HLA-DR/CD14,TNF-α and IL-10 of pre-treatment,24 h and 72 h post-treatment were studied and compared among three groups. Results (1) Three-day (26. 7% vs. 20. 0% vs. 20. 0%) and 7-day mortality rates in blood purification group,hormone group,and control group were 4/15,4/20,4/20 and 5/15,5/20,5/20,respectively,which were the highest in blood purification group,but 28-day mortality rate(5/15 vs.7/20 vs.8/20)was the lowest in blood purification group. (2) PCIS,the expressions of HLA-DR/CD14,CD4 +,CD8 +and CD4 +/CD8 +increased in all groups while they increased significantly in blood purification group(P<0. 05). The levels of TNF-α and IL-10 in peripheral blood of children decreased gradually in each group,especially in blood purification group. Conclusion Comparing with hormone group, continuous blood purification therapy can remove inflammatory mediators more quickly and effectively,reduce cytokine level and improve cellular immune function in children with severe sepsis/septic shock,and reduce their 28-day mortality.
