Dynamic Changes And Clinical Meanings Of Immunological In Severe Sepsis Postoperative Patients

[Objective] To investigate the dynamic state diversify of the immunefunction(immunoglobulin: IgA,IgG,IgM, the complement-3,4 and the peripheral T lymphocyte subsets: CD3,CD4,CD4/CD8) in serious sepsis patients and an effect to the prognosis of patients with the changes of all kinds of immune indexes. To provide reference for the immune treatment.[Methods] 47cases were divided into 3 groups:A, B, C. Among them ,A group is 20patients without obvious infection in their abdomens,B group 15 patients who were infected with serious sepsis,but no organ dysfunction,C group 12 patients with serious sepsis and septic shock..5ml peripheral blood was withdrawn in A group preoperative and put into a common tube and a heparin tube.5ml blood was withdrawn in 1, 3,7days in A,B,Cgroups post-op,then putting into the common tubes and the heparin tubes .The peripheral T lymphocyte subsets CD3,CD4,CD4/CD, immunoglobulin IgA,IgG,IgM and complement -3, 4 were measured.[Results] Compared with the preoperative immune functions ,there was significantdifference among IgA,IgM,IgG complement-3,4 in the first days in group A postoperative ,but from then on , IgA,IgM,IgG and complement-3,4 go up obviously to preoperative level in the postoperative seventh day. Compared with the level of complement-3,4 IgA,IgM,IgG in preoperation and the post-op seventh day ,there was not significant difference (P > 0.05)..IgA,IgG,IgM,complement-3,4 showed no significant difference in the post-op first,third and seventh day between group A and group.B (P> 0.05)..In the first third and seventh day ,the levels of IgA,IgG IgM and complement-3,4 in group C were lower in group C were lower than in group A,B and there was significant difference(P<0.05).Compared with the preoperative level, CD3,CD4,CD4/CD8 in the first and third day in groupA were lower obviously and showed significant difference (P<0.05).In the seventh day , CD3,CD4 went up and there was not significant difference with the preoperative level(P>0.05). in the post-op first,third day, CD3,CD4,CD4/CD8 in groupA and groupB subsided and those went up abruptly in the seventh day, there was not significant difference between groupA and groupB at the same time(P>0.05).But those in groupC subsided obviously in the first,third and seventh day ,compared with their level in groupA,B there was significant difference(P<0.05).[Conclusion] Operation has less effect on immunoglobulin,but the levels of IgA,IgGIgM and complement-3,4 in severe sepsis and septic shock patients were consistantly lower, operation obviously inhibits C3,C4,CD3,CD4,CD4/CD8.in first and third day after operation ,those elements go up obviously .As to the patients in serious sepsis and septic shock C3,C4,CD3,CD4andCD4/CD8 subside obviously.With deterioration of patient's condition ,those elements will keep on low.If patients turn to be good ,the condition may be opposition.