The Changes Of CD4+/CD8+ On Patients Of Sepsis With Mechanical Ventilation Under Analgesia And Sedation

Objective: To observe the relationship of changes of WBC,PCT,CRP,TNF-α(measured by ELISA),IL-10(measured by ELISA),the percentage of CD4+ T cells(measured by the flow cytometer),the percentage of T CD8+ cells,the ratio of CD4+/CD8+ of the peripheral blood in analgesic and sedative patients with mechanical ventilation as time goes on,so that we can acknowledge the immunization of sepsis patients’ characteristics,and then provide better basic theory for patients of sepsis with mechanical ventilation on the point of immunization.Methods: We collected plasma from 40 patients of sepsis with mechanical ventilation and under analgesia and sedation who met the diagnostic criteria and exclusion criteria for the intensive care unit of Affiliated Nanhua hospital,University of South China from August 2016 to October 2017.Quantitative the inflammatory cytokines(WBC,PCT,CRP,TNF-α,IL-10)and immune indice(the percentage of CD4+ T cells,the percentage of CD8+ T cells,the ratio of CD4+/CD8+)of patients of sepsis with mechanical ventilation and under analgesia and sedation,analyse the regularity of inflammatory cytokines and immune indice by the changes of the data as the time goes when the patients begin to use the mechanical ventilation(as the 0 hour),24 hours,48 hours and 72 hours.Results: 1.The value of WBC,PCT,CRP,TNF-α,IL-10 in peripheral blood of patients with sepsis mechanical ventilation under analgesia and sedation who was trained for active treatment tends to drop off over time,it had a statistical significance(P<0.05).2.The percentage of CD4+ T cells and the ratio of CD4+/CD8+ decreased at time 0h-24 h and then increased at time 24-72 h,which had a statistical significance(P<0.05).3.The percentage of CD8+ T cells increased at time 0h-24 h and then decreased at time 24-72 h,which had a statistical significance(P<0.05).Conclusion: 1.At early stages of the patients of sepsis with mechanical ventilation,the inflammatory factors(WBC,PCT,CRP,TNF-α,IL-10)are explosively released,and after the therapy of analgesia and sedation and other active treatment measures,the inflammatory cytokines(WBC,PCT,CRP,TNF-α,IL-10)decreased as the time goes,it had a statistical significance(P<0.05).2.The patients of sepsis with mechanical ventilation had an impaired immunity at early stages,and after the therapy of analgesia and sedation and other treatment measures,the immunization was improved gradually.