目的 分析小劑量甲潑尼龍對膿毒血癥患者療效及對免疫細(xì)胞的影響。方法 回顧性分析2014年10月-2016年10月到普陀區(qū)利群醫(yī)院診治的膿毒血癥患者共72例，每組36例，對照組患者給予常規(guī)抗感染治療，觀察組患者在此基礎(chǔ)上配合小劑量甲潑尼龍治療，均連續(xù)治療7 d，比較兩組患者療效和治療前后免疫細(xì)胞、炎癥因子水平。結(jié)果 觀察組患者生存率為80.56%，明顯高于對照組的55.56%，差異有統(tǒng)計學(xué)意義（P<0.05），并發(fā)癥發(fā)生率未表現(xiàn)出明顯差異。治療前兩組患者免疫細(xì)胞水平未表現(xiàn)出明顯差異，治療后觀察組CD4⁺ T淋巴細(xì)胞、CD8⁺ T淋巴細(xì)胞均明顯高于對照組，CD4⁺/CD8⁺明顯低于對照組，組間差異有統(tǒng)計學(xué)意義（P<0.05）；治療后觀察組血清C反應(yīng)蛋白（CRP）、腫瘤壞死因子-α（TNF-α）、降鈣素原（PCT）、白細(xì)胞介素-1（IL-1）等炎癥因子水平均明顯低于對照組，差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 小劑量甲潑尼龍用于膿毒血癥患者療效確切，能夠有效調(diào)節(jié)T淋巴細(xì)胞和炎癥因子水平，降低機(jī)體免疫反應(yīng)，提高生存率，推薦臨床推廣應(yīng)用。

Objective To investigate the effect of small dosage of methylprednisolone in treatment of sepsis and the influence on immune cells. Methods Totally 72 patients diagnosed with sepsis in Liqun Hospital from October 2014 to October 2016 were selected in this research. They were randomly divided into two groups:36 patients in control group received conventional anti-infective treatment, and 36 patients in observation group were treated with small dosage of methylprednisolone on the basis of control group. The efficacy and level of immune cells were compared in two groups. Results The survival rate in observation group was significantly higher than that of control group (P<0.05). The difference of the incidence of complications and the level of immune cells before treatment between two groups had not statistical significance. CD4⁺ T lymphocytes and CD8⁺ T lymphocytes in observation group were significantly higher than those of control group after treatment, whereas the ratio of CD4⁺/CD8⁺ and levels of CRP, TNF-α, PCT and IL-1 were lower than those of control group (P<0.05). Conclusion There is a significant effect of small dosage of methylprednisolone in treatment of sepsis, which can regulate apoptosis of T lymphocyte and inflammatory factor, reduce the immune response, improve the survival rate, and recommend the clinical popularization and application.