| 胡凯伦,李玉平,冯仙菊,朱海勇.早期乌司他丁联合胸腺肽α1对多发伤患者的免疫调理作用[J].浙江中西医结合杂志,2016,26(12): |
| 早期乌司他丁联合胸腺肽α1对多发伤患者的免疫调理作用 |
| The immunomodulatory effect of early combined use of ulinastatin and thymosin α1 in patients with multiple injuries |
| 投稿时间：2016-06-24 修订日期：2016-08-18 |
| DOI： |
| 中文关键词: 乌司他丁 胸腺肽α1 多发伤 多器官功能障碍综合征 免疫调理 |
| 英文关键词:Ulinastatin Thymosin α1 Multiple organ dysfunction syndrome (MODS) Multiple injuries Immunomodulation |
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| 中文摘要: |
| 【】 目的 探讨早期乌司他丁联合胸腺肽α1对多发伤患者免疫功能及疗效的影响。方法 多发伤患者60例,ISS评分均>16分,随机分为对照组(28例)和实验组(32例),对照组给予常规治疗,实验组在常规治疗的基础上,自入院当天开始给予乌司他丁(Ulinastatin,UTI)联合胸腺肽α1免疫调理治疗,疗程7d。分别观察两组患者治疗前后急性生理学与慢性健康状况评分系统II(APACHE II )评分；采用酶联免疫吸附测定法检测血清肿瘤坏死因子α(TNF-α)与白介素-6(IL-6)水平；采用流式细胞术检测外周血CD14+单核细胞人白细胞抗原DR(HLA-DR/ CD14+)表达率；统计患者ICU住院天数、多器官功能障碍综合征(MODS)发生率、院内感染发生率及28天病死率。 结果 治疗7d后实验组APACHE II 评分较对照组降低,差异有统计学意义(P<0.05)；实验组血清TNF-α水平较对照组下降(P <0.01),IL-6水平较对照组亦下降(P<0.05)；实验组HLA-DR/ CD14+ 表达率明显高于对照组(P<0.01)；实验组ICU住院天数、MODS发生率、院内感染发生率均低于对照组(P均<0.05),28天病死率两组比较无差异(P>0.05)。结论 乌司他丁联合胸腺肽α1免疫调理治疗能够改善多发伤患者的免疫状态,修复促炎/抗炎失衡,降低APACHE II评分,缩短ICU住院时间,减低MODS及院内感染发生率。 |
| 英文摘要: |
| 【】 Objective To investigate the immunomodulatory and therapeutic effects of early combined use of ulinastatin and thymosin α1 in patients with multiple injuries. Methods The patients with multiple injuries (all ISS >16) were randomly divided into two groups,control group (28 cases)and experimental group (32 cases)．In the control group,the patients were treated with regular therapy,and in the experimental group,the early combined use of ulinastatin and thymosin α1 was added for 7 d. The acute physiology and chronic health evaluation (APACHE)Ⅱscore was calculated,the concentrations of tumor necrosis factor alpha (TNF-α) and interleukin-6(IL-6) were determined by enzyme-linked immunosorbent assay and the CD14+ monocyte human leukocyte antigen D-related (HLA-DR) expression was detected by flow cytometry before and after the treatment．Hospitalization days in ICU, 28-day mortality and rate of MODS and infection were recorded. Results After 7 d treatment,the APACHE Ⅱscore in the experimental group was lower than the control group( P<0.05)．In the experimental group,lower levels of TNF-α(P<0.01) and IL-6 (P<0.05) on day 7 as compared to the control group．Patients in experimental group had significantly higher CD14+ monocyte HLA-DR expression than the control group on day 7(P<0.01).The hospitalization days in ICU and rate of MODS and infection in experimental group all showed lower than the control group( all P<0.05),while the 28-day mortality did not (P>0.05)．Conclusion The therapy early combined use of ulinastatin and thymosin α1 could improve the immune function of patients with multiple injuries, repair the imbalance between pro-inflammation an anti- inflammation,decrease the APACHE II score and shorten the hospitalization days in ICU and rate of MODS and infection. |
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