维持性血液透析患者T细胞亚群的变化对并发肺部感染的影响及对策
|
摘要
目的:T细胞亚群的变化在进行维持性血液透析的患者中并发肺部感染的影响及临床意义。方法:选取进行维持性血液透析治疗的患者100例,随机分成对照组和观察组,比较两组患者肺部感染的几率。两组都定期测定各项免疫指标,其中对照组患者进行维持性血液透析等各项常规治疗,观察组在对照组的基础上,如果检测的各项指标提示免疫功能较之前下降,给予免疫增强剂治疗足够的疗程。结果:经治疗后,对照组患者肺部感染发生率为26%,观察组患者肺部感染发生率为12%,可见观察组患者肺部感染发生率明显低于对照组患者,差异具有统计学意义(P<0.05)。经持续性血液透析后对照组患者的T细胞亚群减少幅度明显大于观察组患者,差异具有统计学意义(P<0.05)。结论:研究发现,给予免疫增强剂治疗后的患者T细胞亚群减少幅度小,在进行维持性血液透析治疗过程中并发肺部感染的比例下降,应在临床推广应用。
Objective The effect of T cell subsets on pulmonary infection in maintenance hemodialysis patients and its clinical significance.Method 100 patients undergoing maintenance hemodialysis were selected and randomly divided into the control group and the observation group.The risk of pulmonary infection was compared between the two groups.In the two groups,all the immune indexes were measured regularly,among which the patients in the control group were treated with the routine treatment of maintenance hemodialysis.On the basis of the control group,the observation group suggested that the immune function was lower,the immune enhancement agent was given a sufficient course of treatment,and 50 cases of healthy physical examination at the same time were selected as positive.Regular group.Results After treatment,the incidence of pulmonary infection in the control group was 26%.The incidence of pulmonary infection in the observation group was 12%,which showed that the incidence of pulmonary infection in the observation group was significantly lower than that of the control group(P<0.05).After continuous hemodialysis,the decrease of T cell subsets in the control group was significantly greater than that in the observation group,and the difference was statistically significant(P<0.05).Conclusion The study found that the changes in T cell subsets in patients with enhanced immunization can significantly reduce the proportion of pulmonary infection in maintenance hemodialysis patients,and should be used in clinical application.
Objective The effect of T cell subsets on pulmonary infection in maintenance hemodialysis patients and its clinical significance.Method 100 patients undergoing maintenance hemodialysis were selected and randomly divided into the control group and the observation group.The risk of pulmonary infection was compared between the two groups.In the two groups,all the immune indexes were measured regularly,among which the patients in the control group were treated with the routine treatment of maintenance hemodialysis.On the basis of the control group,the observation group suggested that the immune function was lower,the immune enhancement agent was given a sufficient course of treatment,and 50 cases of healthy physical examination at the same time were selected as positive.Regular group.Results After treatment,the incidence of pulmonary infection in the control group was 26%.The incidence of pulmonary infection in the observation group was 12%,which showed that the incidence of pulmonary infection in the observation group was significantly lower than that of the control group(P<0.05).After continuous hemodialysis,the decrease of T cell subsets in the control group was significantly greater than that in the observation group,and the difference was statistically significant(P<0.05).Conclusion The study found that the changes in T cell subsets in patients with enhanced immunization can significantly reduce the proportion of pulmonary infection in maintenance hemodialysis patients,and should be used in clinical application.
引文
[1] 梁辑,吴清壮.维持性血液透析老年患者合并肺部感染的危险因素[J].中国老年学杂志,2014,34(2):324.
[2] 陈学波,胡玉纹,吴广宇.维持性血液透析患者肺部感染的危险因素分析[J].中华医院感染学杂志,2014,24(11):2706.
[3] 严斌.维持性血液透析患者合并肺部感染的危险因素分析[J].中国医药导刊,2014,16(4):651.
[4] 蔡美英.维持性血液透析患者病毒性肝炎感染预防护理分析[J].中国现代药物应用,2013,7(23):178.
[5] 贾丽芳,冯悦民,王甲正.维持性血液透析患者感染的临床特点及相关因素分析[J].山西医科大学学报,2014,45(1):47.
[6] 冯博,郭立新.中华医学会糖尿病学分会第十七次全国学术会议纪要[J].中国糖尿病杂志,2014,6(1):112.
[7] Parchwani DN,Palandurkar KM,Hema Chandan Kumar D,et al.Genetic Predisposition to Diabetic Nephropathy:Evi-dence for a Role of ACE (I/D) Gene Polymorphism in Type 2 Diabetic Population from Kutch Region[J].Indian J Clin Biochem,2015,30(1):43.
[8] 张磊,杜宇,赵佰桥,等.维持性血液透析患者住院原因及相关因素分析[J].中国中西医结合肾病杂志,2015,16(5):435.
[9] He F,Wu X,Xia X,et al.Pneumonia and mortality risk in continuous ambulatory peritoneal dialysis patients with dia-beticnephropathy[J].PLo S One,2013,8(4):e61497.
[10] Zhang Q,Ren H,Xie J,et al.Causes of death in peritoneal dialysis patients with different kidney diseases and comorbidities:a retrospective clinical analysis in a Chinese center[J].Int Urol Nephrol,2014,46(6):1201.
[11] 金洁娜,林昭宇,孙慧燕,等.糖尿病肾病患者血液透析肺部感染临床特点与相关因素分析[J].中华医院感染学杂志,2016,26(4):827.
[12] Mohammed F A.Prediction of Malnutrition Using Modified Subjective Global Assessment -Dialysis Malnutrition Score in Patients on Chronic Hemodialysis[J].Journal of Community Medicine & Health Education,2014,4(3):101.
[13] 谢满静,莫丽霞,罗海凤,等.强化饮食护理干预对维持性血液透析患者营养不良发生率的影响[J].中外医学研究,2014,21(11):106.
[14] 凌扣荣,周文芳,江瑞,等.糖尿病肾病患者血液透析合并肺部感染的危险因素分析[J].中华医院感染学杂志,2013,23(24):58.
[15] Russo D,Bellasi A,Pota A,et al.Effects of phosphorus -restricted diet and phosphate-binding therapy on outcomes in patients with chronic kidney disease[J].J Nephrol,2015,28(1):73.
[16] 李群英,罗丽.糖尿病合并肺部感染应用哌拉西林舒巴坦及氨溴索的疗效研究[J].吉林医学,2016,37(6):1436.
[17] 赵立新,李康,赵月平.老年慢性阻塞性肺疾病患者肺部感染病原菌耐药性分析[J].吉林医学,2017,38(2):335.
[2] 陈学波,胡玉纹,吴广宇.维持性血液透析患者肺部感染的危险因素分析[J].中华医院感染学杂志,2014,24(11):2706.
[3] 严斌.维持性血液透析患者合并肺部感染的危险因素分析[J].中国医药导刊,2014,16(4):651.
[4] 蔡美英.维持性血液透析患者病毒性肝炎感染预防护理分析[J].中国现代药物应用,2013,7(23):178.
[5] 贾丽芳,冯悦民,王甲正.维持性血液透析患者感染的临床特点及相关因素分析[J].山西医科大学学报,2014,45(1):47.
[6] 冯博,郭立新.中华医学会糖尿病学分会第十七次全国学术会议纪要[J].中国糖尿病杂志,2014,6(1):112.
[7] Parchwani DN,Palandurkar KM,Hema Chandan Kumar D,et al.Genetic Predisposition to Diabetic Nephropathy:Evi-dence for a Role of ACE (I/D) Gene Polymorphism in Type 2 Diabetic Population from Kutch Region[J].Indian J Clin Biochem,2015,30(1):43.
[8] 张磊,杜宇,赵佰桥,等.维持性血液透析患者住院原因及相关因素分析[J].中国中西医结合肾病杂志,2015,16(5):435.
[9] He F,Wu X,Xia X,et al.Pneumonia and mortality risk in continuous ambulatory peritoneal dialysis patients with dia-beticnephropathy[J].PLo S One,2013,8(4):e61497.
[10] Zhang Q,Ren H,Xie J,et al.Causes of death in peritoneal dialysis patients with different kidney diseases and comorbidities:a retrospective clinical analysis in a Chinese center[J].Int Urol Nephrol,2014,46(6):1201.
[11] 金洁娜,林昭宇,孙慧燕,等.糖尿病肾病患者血液透析肺部感染临床特点与相关因素分析[J].中华医院感染学杂志,2016,26(4):827.
[12] Mohammed F A.Prediction of Malnutrition Using Modified Subjective Global Assessment -Dialysis Malnutrition Score in Patients on Chronic Hemodialysis[J].Journal of Community Medicine & Health Education,2014,4(3):101.
[13] 谢满静,莫丽霞,罗海凤,等.强化饮食护理干预对维持性血液透析患者营养不良发生率的影响[J].中外医学研究,2014,21(11):106.
[14] 凌扣荣,周文芳,江瑞,等.糖尿病肾病患者血液透析合并肺部感染的危险因素分析[J].中华医院感染学杂志,2013,23(24):58.
[15] Russo D,Bellasi A,Pota A,et al.Effects of phosphorus -restricted diet and phosphate-binding therapy on outcomes in patients with chronic kidney disease[J].J Nephrol,2015,28(1):73.
[16] 李群英,罗丽.糖尿病合并肺部感染应用哌拉西林舒巴坦及氨溴索的疗效研究[J].吉林医学,2016,37(6):1436.
[17] 赵立新,李康,赵月平.老年慢性阻塞性肺疾病患者肺部感染病原菌耐药性分析[J].吉林医学,2017,38(2):335.