血必净注射液对严重创伤患者外周血T淋巴细胞亚群变化的干预研究  

An intervention study of Xuebijing injection(血必净注射液) on peripheral T-lymphocyte subpopulations in patients with severe trauma

作　　者：周忠东[1] 陆远强[2] 杨林[3] 陈大方[3] 黄卫东[2] 

机构地区：[1]浙江省绍兴市中医院药剂科,浙江绍兴312000 [2]浙江大学医学院附属第一医院急诊科,浙江杭州310003 [3]浙江大学医学院邵逸夫医院危重医学科,浙江杭州310016

出　　处：《中国中西医结合急救杂志》2008年第2期108-110,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：浙江省中医药科研基金资助项目(2005C052)

摘　　要：目的探讨血必净注射液对严重创伤患者外周血T淋巴细胞亚群变化的影响及其临床意义。方法将33例严重创伤患者随机分为对照组(16例)和血必净治疗组(17例)。对照组患者给予常规救治,血必净治疗组患者则在常规救治的基础上早期加用血必净注射液治疗。采用双抗体标记流式细胞分析技术测定患者入院时、伤后3 d和5 d的外周血T淋巴细胞及其亚群CD4+、CD8+的百分率及CD4+/CD8+比值。结果两组严重创伤患者伤后3 d和5 d时,外周血CD4+和CD4+/CD8+比值均较入院时明显下降〔CD4+:对照组为(32.40±6.02)%、(34.19±5.63)%比(45.09±6.57)%,治疗组为(34.30±5.46)%、(38.55±6.47)%比(46.10±6.02)%;CD4+/CD8+比值:对照组为1.11±0.20、1.15±0.20比1.60±0.20,治疗组为1.20±0.22、1.32±0.24比1.66±0.24,P均<0.01〕。伤后5 d时,血必净治疗组患者的外周血CD4+和CD4+/CD8+比值明显回升〔(38.55±6.47)%、1.32±0.24〕,与对照组〔(34.19±5.63)%、1.15±0.20〕比较差异有统计学意义(P均<0.05)。结论严重创伤患者在常规救治的基础上早期使用血必净注射液,能较快纠正T细胞辅助/抑制免疫炎症调节网络的紊乱或抑制,有助于维持免疫炎症调节功能的平衡。Objective To investigate the effect and clinical significance of Xuebijing injection （血必净注射液）on peripheral T-lymphocyte subpopulations in patients with severe trauma. Methods Thirty-three patients with severe trauma were divided into a control group （n= 16） and a treatment group （n= 17）. The patients of two groups were all treated conventionally, and the only difference was that Xuebijing injection was given to the treatment group at the early stage. The CD4^＋ and CD8^＋ subpopulations of T-lymphocyte in the peripheral blood were detected respectively at admission of hospitalization, and the 3rd and 5th day after trauma by double antibody labeling and flow cytometry. Results The CD4^＋ T-lymphocytes and CD4^＋/CD8^＋ ratio of peripheral blood in patients with severe trauma all decreased markedly at the 3rd and 5th day after trauma [CD4^＋：（32.40±6.02）% and （34.19±5.63）%, respectively vs. （45.09±6.57）% in control group, （34. 30±5. 46）% and （38.55±6.47）%, respectively vs. （46.10±6.02）% in treatment group; CD4^＋/CD8^＋ ratioi 1.11±0.20 and 1.15±0.20, respectively vs. 1.60±0. 20 in control group, 1.20±0.22 and 1.32± 0. 24, respectively vs. 1.66 ±0.24 in treatment group, all P〈0. 013. Furthermore, compared with the control group, the peripheral CD4^＋ T-lymphocytes and CD4^＋/CD8^＋ ratio of treatment group elevated obviously at the 5th day after trauma, the differences being statistically significant [（38.55± 6.47）% and 1.32＋0.24vs. （34.19±5. 63）% and 1.15±0.20 both P〈0.05]. Conclusion In the treatment of patients with severe trauma, on the basis of conventional therapy, the early use of Xuebijing injection can quickly correct the disorder or inhibition of helper/suppressor T-lymphocytes immuno-inflammatory regulating network, and help to maintain a more balanced profile of immunologic function.

关 键 词：血必净注射液 创伤 T淋巴细胞亚群 流式细胞术 

分 类 号：R26[医药卫生—中医外科学]