The Study Of Leucocyte Immune Function Dynamic Changes In Sepsis Patients Within24Hours Continuous Blood Purification Treatment

Objective To investigate the impact of Continuous Blood Purification Treatment within24hours on leucocyte immune function in patients with sepsis.Methods Patients were selected from September2011to January2012in Intensive Care Unit of the First Affiliated Hospital of Guangxi Medical University. Twenty cases who met sepsis diagnostic criteria were enrolled in this study. They were treated with continuous blood purification treatment (CBP) and conventional therapy.C-reactive protein (CRP), CD4+/CD8+ratio, neutrophil phagocytic rate and neutrophil phagocytic index, renal function, electrolytes, and serum lactate level were measured before treatment and at the time of8hours,16hours,24hours after treatment. Patients’temperature, respiratory rate, heart rate, mean arterial pressure (MAP) were recorded before treatment and at8hours,16hours, and24hours after treatment; while the APACHE Ⅱ scores were evaluated every12hours.Results There was no significant difference in MAP compared the values before and after8hours,16hours and24hours treatment (P>0.05). Patients’heart rates (HR), temperature, respiratory rate significantly decreased after8hours,16hours and24hours treatment (P<0.05), but they were still in normal range. CRP significantly decreased after8hours of treatment(P<0.05), and after16hours treatment (P<0.01); however, the values slightly increased after24hours treatment, there was a significant difference in CRP between after24hours treatment and before treatment, the value was lower after24hours treatment (P<0.05); There was a significant increase in CD4+/CD8+ratio, neutrophil phagocytic rate and neutrophil phagocytic index after8hours treatment (P<0.05), and after16hours treatment (P<0.01); although there was a slight decrease in CD4+/CD8+ratio, neutrophil phagocytic rate and neutrophil phagocytic index after24hours of treatment, there was a significant difference in those values between before treatment and after24hours treatment, the values were lower after24hours treatment (P<0.05). There was a significant decrease in Blood Urea Nitrogen (BUN) and Serum Creatinine (SCr) after8hours and16hours treatment (P<0.05), and after24hours treatment (P<0.01) compared with that before treatment. There was no significant difference in Sodium (Na), potassium (K) and Chlorine (Cl) between after treatment and before treatment (P>0.05). Blood pH and HCO3significantly increased after8hours,16hours and24hours treatment (P0.05). Blood lactic acid value significantly decreased after8hours and16hours treatment (P<0.05), and after24hour treatment (P<0.01) compared with that before treatment. APACHE Ⅱ score significantly decreased after12hours and24hours treatment compared with that before treatment(P<0.05).Conclusion Continuous blood purification treatment could increase CD4+/CD8+ratio, neutrophil phagocytic rate and neutrophil phagocytic index and decrease CRP level, thus could correct the patient’s immune paralysis situation and facilitate recovering the immune function. The strongest effect in increasing CD4+/CD8+ratio, neutrophil phagocytic rate and neutrophil phagocytic index, and in decreasing CRP level was seen after16hours treatment. CBP could decrease APACHE II score in patients with sepsis, thus improve patients’ conditions. It is one of the important treatment for sepsis.