Effects Of Different Fluid-restricted Resuscitation On The Expression Of Th17,Treg Cells And Related Cytokines In Peripheral Blood Of Patients With Traumatic Hemorrhagic Shock And Its Clinical Significance

Objective:To investigate the effect and clinical significance of different resuscitation fluid resuscitation in patients with hemorrhagic shock on the percentage of Th17 and Treg cells in peripheral blood and related cytokines,and to provide reference for clinical screening of relatively ideal resuscitation fluid.Methods:Fifty-six patients with traumatic hemorrhagic shock who were admitted to the emergency department of the First Affiliated Hospital of Bengbu Medical College from January 2016 to June 2019 were selected as the research subjects.All patients were randomly divided into sodium acetate Ringer's solution(AR)And sodium lactate Ringer's solution(LR)group,28 cases each;the AR group and the LR group were set to T0 before resuscitation,T1 30 minutes after resuscitation,and T2 1 h after resuscitation.Eighteen volunteers of healthy doctors in our hospital were selected as the control group.Peripheral blood was collected,and the ratio of Th17 cells and Treg cells in each group was detected by flow cytometry(FCM).IL-17,IL-6,IL-,and peripheral blood were detected by double antibody sandwich enzyme-linked immunosorbent assay(ELISA).10.Contents of IL-23,TNF-?,laboratory tests such as blood routine and blood coagulation function,and score of trauma severity.Results:Compared with the control group,the peripheral blood Th17,Treg ratio and cytokine levels in the trauma group(including AR group and LR group)increased,and the differences were statistically significant(all P values<0.05).There was no significant difference in the ratio of Th17,Treg,and cytokines in T0 stage peripheral blood between patients in AR group and LR group(both P>0.05).The ratio of Th17,Treg and cells in peripheral blood between T0 and T1 stages in the two groups were not significant.The difference in the increase in factor levels was tested by paired sample t test.The results showed that the increase of TH17 cells and IL-17,IL-6,IL-10,TNF-? in the AR group was smaller than that in the LR group,and the differences were all different.Statistical significance(P<0.05).There was no significant difference in the increase of Treg and IL-23(P>0.05).Patients in the two groups were exposed to 30 minutes(T1)to 1 hour(T2)after resuscitation.The difference was not statistically significant(P>0.05).It is suggested that the AR group may reduce the increase of inflammatory factor levels in patients at the early stage of fluid resuscitation of traumatic hemorrhagic shock compared with the LR group.Conclusions:(1)Compared with sodium lactate Ringer's solution,the recovery of patients with traumatic hemorrhagic shock using sodium acetate Ringer's solution can significantly inhibit the release of peripheral blood Th7 cells and IL-17,IL-6,TNF-?in the early stage of fluid resuscitation,and increase The expression of IL-10 suggests that the application of sodium acetate Ringer fluid resuscitation is beneficial to reduce the systemic inflammatory response in patients with traumatic hemorrhagic shock.(2)Th17,Treg cells and related cytokines are closely related to the occurrence and development of traumatic hemorrhagic shock.