乌司他丁联合胸腺肽对脓毒血症患者血清炎症因子、黏附因子及免疫细胞亚群的影响

发布时间：2018-03-08 05:36

本文选题：脓毒血症　切入点：乌司他丁　出处：《山东医药》2017年41期 　论文类型：期刊论文

【摘要】：目的探讨乌司他丁联合胸腺肽对脓毒血症患者血清炎症因子、黏附因子及免疫细胞亚群的影响。方法选择脓毒血症患者178例,根据治疗方法不同分为对照组58例、乌司他丁组60例、联合组60例,患者早期均给予广谱抗生素,容量复苏,小剂量激素,纠正水电解质紊乱,连续性血液净化治疗,乌司他丁组将乌司他丁300 000 U加入5%的葡萄糖溶液100 m L中静点,3次/d,治疗5 d。联合组在此基础上皮下注射胸腺肽,1.6 mg/次,2次/d,均连续5 d。观察三组治疗前后血清C反应蛋白(CRP)、降钙素(PCT)、肾上腺髓质前体(Pro-ADM)、肿瘤坏死因子α(TNF-α)、IL-6、白细胞介素1β(IL-1β)、IL-10、血栓调节蛋白(s TM)、血管性假血友病因子(v WF)、内皮素1(ET-1)水平变化及免疫细胞亚群CD4~+、CD3~+、CD8~+、CD4~+/CD8~+变化。结果治疗后,三组血清CRP、PCT、Pro-ADM、TNF-α、IL-6、IL-1β、IL-10、s TM、v WF、ET-1较治疗前均降低(P均0.05),CD4~+、CD4~+/CD8~+、CD3~+较治疗前均升高(P均0.05),尤以联合组为著,三组比较,P均0.05。对照组及乌司他丁组CD8~+虽较治疗前下降,但差异无统计学意义;联合组CD8~+较治疗前下降(P0.05)。结论乌司他丁联合胸腺肽治疗脓毒血症患者,可降低患者血清IL-1β、TNF-α、IL-6、IL-10、Pro-ADM、sTM、vWF、ET-1水平,并调节CD4~+、CD4~+/CD8~+、CD3~+等免疫细胞亚群。
[Abstract]:Objective to investigate the effects of ulinastatin combined with thymosin on serum inflammatory factors, adhesion factors and immune cell subsets in patients with sepsis. Patients in ulinastatin group (n = 60) and combined group (n = 60) were treated with broad-spectrum antibiotics, volume resuscitation, low-dose hormones, correction of water and electrolyte disorders, and continuous blood purification therapy. In the ulinastatin group, 300000 U ulinastatin was added to 5% mL glucose solution for 5 days. On this basis, the combined group was subcutaneously injected with thymosin 1. 6 mg/ twice a day for 5 days. The blood was observed before and after treatment. Serum C-reactive protein (CRP), calcitonin (PCT), Pro-ADMN, tumor necrosis factor 伪 (TNF- 伪), interleukin-1 尾 (IL-1 尾), thrombomodulin (TMs), von Willebrand factor (v WF, endothelin 1ET-1) and immune cell subsets (CD4 ~ + CD3 ~ + CD8 ~ CD4 ~ +). After treatment, Compared with before treatment, the serum levels of CRP PCT, Pro-ADMN, TNF- 伪, IL-6, IL-1 尾, IL-10, TNF- 尾, IL-10, TNF- 尾, TNF- 尾, IL-10, TNF- 尾, TNF- 伪, IL-10, TNF- 尾, TNF- 伪, IL-10, TNF- 尾, TNF- 伪, IL-6, TNF- 伪, IL-6, TNF- 伪 and IL-10, TNF- 尾, TNF- 尾, IL-10, TNF- 尾, TNF- 尾, IL-10, TNF- 尾, TNF- 尾, IL-10, TNF- 尾, TNF- 尾, IL-10, TNF- 尾, IL-10, TNF- 尾, IL-10, TNF-. Conclusion Ulinastatin combined with thymosin in the treatment of sepsis patients can reduce the level of serum IL-1 尾 -TNF- 伪, IL-6, IL-10, Pro-ADMsTMMsTMN, vWFFT-1, and regulate the immune cell subsets of CD4 ~ / CD4 ~ / CD8 ~ CD3 ~.
【作者单位】：广西壮族自治区人民医院;
【分类号】：R459.7

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