目的 探讨脓毒症患者血清生长激素、胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)水平与免疫功能的关系.方法 选择资料完整的42例脓毒症患者,检测其血清生长激素、IGF-1及其外周血中T淋巴细胞亚群、体液免疫五项.采用多因素重复测量方差分析比较脓毒症与对照组的各项指标,偏相关分析研究生长激素、IGF-1与免疫功能的关系.结果 脓毒症患者血清生长激素明显高于对照组(P =0.013 7,0.012 3,0.011 5),IGF-1明显低于对照组(P=0.014 4,0.013 5,0.013 2);同时脓毒症组患者外周血中CD3+(P =0.009 5,0.008 9,0.0092)、CD4+ (P=0.0163,0.013,0.015 8)、CD8+(P=0.010 1,0.0193,0.015 5)、NK (P=0.023 4,0.029 3,0.025 5)及CD19+细胞(P=0.011 3,0.0102,0.0100)、IgA (P =0.019 3,0.017 8,0.015 7)、IgG (P=0.0047,0.0069,0.0059)、补体C3 (P=0.039 3,0.037 8,0.0456)明显低于对照组.患者IGF-1和CD3+、CD4+、CD8+、CD19+、NK细胞及IgA、IgG、补体C3(P=0.013,0.036,0.015,0.008,0.002,0.005,0.009,0.001)呈正相关.结论 脓毒症患者血清生长激素、IGF-1、细胞免疫、体液免疫水平均有异常,其中IGF-1与免疫功能具有相关性,将影响脓毒症患者的预后.

作者：游婷婷；石松菁

来源：中华急诊医学杂志 2017 年 26卷 12期