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目的术创伤、脓毒症均可通过多种途径影响机体的免疫功能,本文通过对腹部重症脓毒症患者机体免疫指标(免疫球蛋白及补体 IgA、IgG、IgM、C3、C4,为重症脓毒症患者免疫治疗及各免疫指标的变化对严重脓毒症患者预后的影响提供参考。方法将20例腹部无明显感染的患者、15例腹部脓毒症患者不伴器官功能障碍、12例腹部严重脓毒症及脓毒性休克患者分为 A、B、C组,A、B、C 组术后第1、3、7天,各抽取外周静脉血5ml 于普通试管,测定免疫球蛋白及补体(IgA、IgG、IgM、C3、C4)。同时记录生命体征的变化和预后转归。结果 A 组与术前比较,免疫球蛋白在第1天 IgA、IgM、Igc,C3、C4均下降,IgA、IgM 与术前比较,差异有显著性(P<0.05),而补体 C3在第1天明显下降,与术前、术后第7天相比差异均具有显著性(P<0.05),C4下降不明显,无统计学意义(P>0.05),A、B 两组术后第1、3、7天 IgA、IgG、IgM、C3、C4均无显著统计学差异(P>0.05),第1、3、7天 C 组 IgA、IgM、IgG、C3、C4均低,与 A、B 两组相比较明显降低,具有统计学意义(P<0.05)。结论手术创伤对免疫球蛋白影响不大。对于术后重症脓毒症及脓毒性休克患者 IgA、IgM、IgG,C3、C4明显降低,且随病情恶化,持续在较低水平。
The purpose of surgical trauma, sepsis can affect the body’s immune function through a variety of ways. In this paper, the body of severe sepsis patients with immune indicators (immunoglobulin and complement IgA, IgG, IgM, C3, C4, severe pus To provide references for the patients with severe sepsis and their effects on the prognosis of patients with severe sepsis.Methods Twenty patients with no obvious abdominal infection and 15 patients with abdominal sepsis without organ dysfunction and 12 with abdominal Severe sepsis and septic shock patients were divided into A, B, C group, A, B, C group after the first 1,3,7 days, the extraction of peripheral venous blood 5ml in ordinary test tube, determination of immunoglobulin and complement (IgA, IgG, IgM, C3 and C4) .All the changes of vital signs and prognosis were recorded.Results In group A, IgA, IgM, Igc, C3 and C4 all decreased on the first day compared with those before operation, IgA and IgM were significantly different from those before operation (P <0.05), while complement C3 was significantly decreased on the first day, which was significantly different from preoperative and postoperative day 7 (P <0.05) C4 was not significantly decreased (P> 0.05), IgA, IgG, Ig There was no significant difference between M, C3 and C4 (P> 0.05). The levels of IgA, IgM, IgG, C3 and C4 in group C on the 1st, 3rd and 7th day were all lower than those in the A and B groups (P0.05) .Conclusion Surgical trauma has little effect on immunoglobulin, but IgA, IgM, IgG, C3 and C4 in patients with severe sepsis and septic shock after operation are significantly lower, and continue to worsen with the progression of the disease At a lower level.