中药方剂对重症胰腺炎患者细胞免疫及病情的影响  

Effect of traditional Chinese medicine on the cellular immunity of severe acute pancreatitis patients

作　　者：邢金燕[1] 张顺[1] 孙运波[1] 杜春艳[1] 韩小宁[1] 

机构地区：[1]青岛大学医学院附属医院ICU,266003

出　　处：《中国急救医学》2007年第4期307-310,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的观察重症胰腺炎(SAP)患者淋巴细胞及单核细胞的功能细胞数量变化及中药对其影响。方法40例SAP患者随机分为常规治疗组和中药组,记录两组患者在治疗第0、3、7、10天淋巴细胞计数、CD3比例、CD4比例、CD8比例、CD14HLA-DR比例及血浆前白蛋白(PA)、C反应蛋白(CRP)变化情况,并同时按急性生理及慢性健康状况评分(APACHEⅡ评分)和器官衰竭评分(Marshall评分)进行评价。另取15名健康志愿者为健康对照组。结果入选时SAP患者APACHEⅡ评分和Marshall评分均较高,与键康对照组比较,淋巴细胞计数、CD3比例、CD4比例、CD4/CD8比例、CD14HLA-DR比例、PA明显降低,同时CD8比例、CRP明显升高;经治疗患者的APACHEⅡ和Marshall评分下降,淋巴细胞计数、CD3比例、CD4比例、CD14HLA-DR比例、PA升高,CD4/CD8比例趋于正常,CRP降低,改变以中药组较早且明显,死亡患者的CD14HLA-DR比例明显低于存活者。结论SAP患者存在细胞免疫功能障碍,表现为淋巴细胞总数降低,比例异常,同时单核细胞抗原递呈细胞比例降低,随病情改善细胞免疫功能改善,中药应用有助于改善SAP患者淋巴细胞免疫异常,提高CD14HLA-DR比例。Objective To observe the changes of lymphocyte, its subsets and the CD14 monocyte human leukocyte antigen（ HLA ） - DR cell of severe acute pancreatitis（SAP）, and the effect of traditional Chinese medicine on them. Methods 40 SAP patients were divided into routine treatment group and traditional Chinese medicine group at random. For all SAP patients, the scores of APACHE U and Marshall were recorded at the 0, 3rd, 7th, 10th day, at the same time the number of lymphocyte and the percentage of CD14HLA -DR cell and different subsets including CD3, CD4, CD8, CD4/CD8 were measured, the plasma levels of prealbumin（PA） and C reactive protein（ CRP） were observed. 15 healthy person were chosen as the control group. Result Before the treatment, the scores of APACHE II and SOFA of SAP patients were high. Compared with control group, the number of lymphocyte and the percentages of CD3, CD4 was decreased, especially the CD14HLA - DR and the CD4/CD8, at the same time the plasma levels of PA declined and CD8, CRP were higher. After the treatment, the scores of APACHE Ⅱ and SOFA of two groups were all decreased, the number of lymphocyte and the percentage of CD3, CD4, CD14HLA - DR and PA rose, and CD4/CD8 tended to normal, the condition of the patients with SAP were improved. CRP declined. The traditional Chinese medicine group changed more significantly and early. Conclusion sAP cause the suppression of peripheral blood lymphocyte and its subsets, and the percentage of CD14HLA - DR declined significantly. After the treatment the abnormalities of lymphocyte and its subsets were corrected. The traditional Chinese medicine can help to improve the cellular immune function and the condition of patients with SAP.

关 键 词：重症胰腺炎 淋巴细胞 免疫 CD14人白细胞抗原-DR 中药 

分 类 号：R259[医药卫生—中西医结合]