Clinical study of the immunopotentiation therapy in the patients with severe sepsis

Objective: To explore the cellular immunity state in the patients with severe sepsis and influences of immunemodulation therapy with Thymosin α1.Methods: 135 patients with severe sepsis in our hospital from February 2010 to February 2011 were enrolled.The trends of serum CD14 + monocyte HLA-DR levels,the absolute counting of T lymphocytes subpopulation were monitored.And the patients with severe sepsis were randomly divided into two groups by the absolute counting of CD4 +T lymphocytes subpopulation410 cells/μl.The patients in control group were treated with classical SSC therapy,those in treatment group were treated with Thymosin α1,1.6 mg subcutaneous injection per day,continued 7 days and classical SSC therapy.Levels of above immune indexes were detected before treatment and after 3 days and 7 days of treatment.Results: Levels of serum HLA-DR,CD3 +,CD4 +,CD8 + T lymphocyte were significantly decreased in 85 patients with severe sepsis.Levels of serum HLA-DR,CD3 +,CD4 +,CD8 + T lymphocyte were increased significantly after 7 days treatment in treatment group.These parameters were higher after 7 days than after 3 days(P0.05 or P0.01).Compared with the variables at the same period in the control group,CD3 + T lymphocytes after 3 days and HLA-DR,CD3 +,CD4 +,CD8 + after 7 days were increased significantly treatment in treatment group,but differences between ratio of CD4 +/CD8 + were not statistically significant.Subgroup-analysis showed that there was a increasing tendency in short term for slight or midrange immune-depression patients in treatment group.Levels of serum CD3 +were only increased after 7 days for severe immunedepression patients(P0.05).Conclusion: The cellular immune-depression is existed in patients with severe sepsis.Thymosin α1 can increase cellular immunity.There are more effective in slight or midrange immune-depression,and severe immunedepression patients also benefit from continuous treatment.