| Objective:By using two implementing kinds of blood purification—CVVH andCVVHDF regulating the balance of Th1/Th2in MODS patients,we want toinvestigate the clinical and immunological value of the CVVHDF and CVVHtreatment in MODS.Methods: there were20specimens collected from healthy volunteers(2013-2014Zunyi Medical College Hospital Medical Branch set to be the control group.A total of60patients with multiple organ dysfunction syndrome (MODS) were divided into threegroups randomly,treated with conventional treatment (referred to be the conventionaltreatment group)， Continuous veno-venous hemofiltration (CVVH)+conventionaltreatment group (referred to be the CBP1group), continuous veno-venoushemodiafiltration (CVVHDF)+conventional treatment group (referred to as CBP2group)respectively； the control group used flow cytometry to detection Th1, Th2and Th1/Th2,and extracellular IFN-gamma, IL-4and the ratio of IFN-gamma/IL-4were detected byELISA. Conventional treatment group, CBP1, CBP2group before treatment and aftertreatment for24h，48h,72h，used flow cytometry and ELISA method monitoring ofintracellular and extracellular the data.Results:1. the flow cytometry detected the intracellular Th1， Th2and Th1/Th2through healthy population (the contral treatment group)were:1.551±0.300%，1.583±0.240%and0.975±0.065. ELISA method for the detection of extracellular IFN-γ,IL-4were:111.286±11.382pg/ml,31.900±3.960pg/ml, and IFN-γ/IL-4was:3.525±4.318;2. After24conventional treatment,there was no statistically significant difference (P>0.05)about intacellular Th1, Th2and Th1/Th2between before and after treament insame group. After48h and72h treament，Th1had increased with the extension oftreatment time,while the Th2gradually reduced, so Th1/Th2was rised.Compared withbefore treatment, the difference was statistically significant (P <0.05); The Expression ofextracellular IFN-gamma was raising with the extension of treatment time, the expressionof IL-4gradually reduced, so IFN-gamma/IL-4rised.Compared with before treatment, thedifference was statistically significant (P <0.05);3. With the extension of treatmenttime,the intracellular Th1of CBP1treatment group and CBP2treatment group had beenincreasing, the expression of Th2gradually reduced, Th1/Th2rised,.Compared withbefore treatment, the differences were statistically significant (P <0.05), treatmentcomparison between each point in time, the difference was statistically significant (P <0.05); With the extension of treatment time,the expression of extracellular IFN-gammahad been increasing, the expression of IL-4gradually reduced, compared with beforetreatment,, the difference of IFN-gamma/IL-4between before and after treament wasstatistically significant (P <0.05), treatment comparison between each point in time, thedifference was statistically significant (P <0.05);4. Compared with conventional treatmentgroup, the Th1(IFN-gamma),Th2(IL-4) and Th1/Th2(IFN-gamma/IL-4) in CBP1andCBP2treatment group had statistically significant differences after24h,48h and72htreament(P <0.05).There was not any difference between CBP1group and CBP2group inthe treatment of24h hours (P>0.05); the expression of Th1(IFN-gamma) graduallyincreased with the extension of treatment time after48h and72h, expression ofTh2(IL-4) decreased, Th1/Th2(IFN-gamma/IL-4) increased, the differences werestatistically significant (P <0.05), Th1(IFN-gamma) increased significantly after48htreament and Th2(IL-4) decreased significantly after72hours of two groups. And after72hours of treatment,Th1(IFN-gamma),Th2(IL-4) and Th1/Th2(IFN-gamma/IL-4) close to the normal. Conclusion:1.CBP can restore the balance of Th1/Th2（IFN-γ/IL-4） in MODS patientsand improve immume function.2.CBP1group (CVVH+the conventional treatment group)and CBP2group(CVVHDF+the conventional treatment group) are more benificial to therecovery of Th1/Th2balance than in the conventional treatment group,while comparedwith CBP1group, CBP2group has more advantages, Both the effect of the two methods ofblood purification treatment peak in the48h. |
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