乌司他丁联合胸腺肽α_1对脓毒症患者免疫调理的合理性分析  

Analysis on the immunoregulation of combined therapy of ulinastatin and thymosin α_1 in the treatment of sepsis

作　　者：苏磊[1] 周殿元[1] 唐柚青[2] 文强[2] 白涛[2] 孟繁甦[2] 唐丽群[2] 段鹏凯[2] 

机构地区：[1]南方医科大学南方医院消化内科,广州510515 [2]广州军区广州总医院ICU

出　　处：《解放军医学杂志》2007年第2期161-163,共3页Medical Journal of Chinese People's Liberation Army

基　　金：广东省自然科学基金资助项目(05000139)

摘　　要：目的探讨乌司他丁联合胸腺肽α1对脓毒症、多器官功能衰竭(MODS)免疫状态的影响,分析其在免疫调理中的合理性。方法46例脓毒症、18例MODS患者均随机分为对照组和治疗组。对照组给予SSC经典治疗,治疗组则给予乌司他丁联合胸腺肽α1免疫调理疗法,进入程序时及治疗结束时采用ELISA方法检测IL-6、IL-10含量。结果脓毒症治疗组IL-6、IL-10明显下降,与脓毒症对照组相比差异显著(P<0.05),进一步将仅给予SSC经典治疗的对照组分为存活亚组和死亡亚组,其中存活亚组IL-6、IL-10在后期均下降,与死亡亚组相比差异显著(P<0.05)。MODS治疗及对照组治疗前后IL-6、IL-10差异无显著性(P>0.05)。结论乌司他丁联合胸腺肽α1能够均衡下降脓毒症炎症/抗炎介质的水平,调整脓毒症免疫状态,但对MODS患者的免疫调理作用有待进一步观察。Objective To observe the influences of combined therapy of ulinastatin and thymosin α1 on the immune state in the treatment of sepsis and multiple organ failure （MODS）, and to evaluate the therapeutic rationality. Methods 46 patients with sepsis and 18 patients with MODS were randomly divided into two groups. The patients in control group were treated with classical SSC therapy, those in treatment group were treated with the combined ulinastatin and thymosin α1 therapy. The contents of IL-6 and IL-10 were detected with ELISA at the beginning of and after the treatment. Results After treatment, the concentrations of IL-6 and IL-10 declined significantly in treatment group, while no apparent changes were observed in the control group. There existed a significant difference between the two groups （P〈0. 05）. To further analyze the survived and dead patients in control group, it was found that the levels of IL-6 and IL-10 decreased in survival subgroup during the late period, and there existed a significant difference compared with the death group （P〈0. 05）. The therapeutic efficiency of the two therapies showed no significant difference on the treatment of MODS. Conclusion Combined ulinastatin and thymosin α1 therapy may modulate the release of cytokines and throw a positive influence on the immune state of sepsis patients. However, the effect of the combined therapy on the treatment of MODS is to be investigated.

关 键 词：脓毒症 多器官功能衰竭 免疫调理 

分 类 号：R392.32[医药卫生—免疫学]