Effect of continuous renal replacement therapy on the function of CD8+T lymphocytes in patients with sepsis / 中国感染控制杂志

ABSTRACT

Objective To investigate the changes in CD8+T lymphocyte count and effect on immune function in patients with sepsis after continuous renal replacement therapy (CRRT).Methods General data of septic patients who admitted to the emergency department of a hospital between October 2015 and August 2016 were collected,pe-ripheral blood was taken from patients before and after single CRRT,the total CD8+T cell count,interferon-γ(IFN-γ)-secreting CD8+T cell count,the levels of inhibitory molecules and costimulatory molecules as well as IFN-γand tumor necrosis factor-α(TNF-α)produced by CD8+T cells were detected.Results A total of 37 hospitalized septic patients were infected with gram-negative bacteria, pathogens causing infection were Klebsiella pneumoniae (22 strains),Acinetobacter baumannii (1 1 strains),and Enterobacter cloacae (3 strains).After CRRT,the body temperature,heart rate,white blood cell count,urea nitrogen,and serum creatinine levels in septic patients were all lower than those before CRRT (all P＜0.05).After CRRT,the total CD8+T cell count in septic patients didn’t change significantly (P＞0.05),but IFN-γ-secreting CD8+T cell count increased (P＜0.05).Levels of cytotoxic T lymphocyte-associated antigen 4(CTLA-4),programmed death-1 (PD-1),T-cell immunoglobulin and mucin-do-main-containing molecule 3 (TIM-3)after CRRT were all lower than those before CRRT (all P＜0.05 ),while levels of costimulatory molecules CD28 and secreting IFN-γ elevated after CRRT(all P＜0.05).Conclusion CRRT can not only improve the vital signs and renal function of patients with sepsis,but also enhance the immune function of CD8+T cells.