乌司他丁对急性左心衰竭患者细胞免疫功能的影响  

Influence of ulinastatin on cellular immune function in the patients of acute left heart failure

作　　者：张谦[1] 周厚荣[1] 杨娇荣[1] 刘海健[1] 郭军[1] 

机构地区：[1]贵州省人民医院急诊科,贵阳550002

出　　处：《中国急救医学》2010年第9期779-781,共3页Chinese Journal of Critical Care Medicine

基　　金：贵州省科技攻关项目（黔科合S字[2007]1052）

摘　　要：目的 研究急性左心衰竭患者细胞免疫功能的变化,以及乌司他丁对急性左心衰竭患者细胞免疫功能的影响.方法 选择符合ESC 2005急性心力衰竭标准的患者38例,随机分为两组,对照组20例（常规强心、利尿、扩血管、抗感染,必要时无创面（鼻）罩正压通气及对症支持治疗）,治疗组18例（乌司他丁＋常规治疗）,检测治疗前及治疗后4、12、24、48 h血清CD4＋、CD8＋、CD4＋/CD8＋、NK的变化.结果 两组治疗后CD4＋、CD8＋、CD4＋/CD8＋均呈升高趋势.CD4＋两组治疗后24 h较治疗前明显升高（P〈0.05）,治疗组较对照组明显升高（P〈0.05）;CD4＋/CD8＋两组治疗前后没有明显变化（P〉0.05）,治疗后24 h治疗组较对照组明显升高（P〈0.05）;CD8＋两组治疗前后组间、组内比较差异均无统计学意义（P〉0.05）.两组治疗后NK细胞呈下降趋势,治疗后12 h的变化较明显（P〈0.05）,治疗组较对照组明显降低（P〈0.05）.结论 急性左心衰竭患者的细胞免疫功能下降,以CD4＋、CD4＋/CD8＋下降为主,并有NK细胞增多.使用乌司他丁能提高CD4＋、CD4＋/CD8＋水平,降低NK细胞水平,改善患者细胞免疫功能.Objective To study the influence of ulinastatin on cellular immune function in the patients of acute left heart failure. Methods 38 patients with acute left heart failure who accorded with diagnostic standard of ESC 2005 acute heart failure were divided into two groups： control group and therapy group. 20 patients in control group were treated with the conventional treatment including cardiac,diuretic,expanding blood vessel, antiinfection, and noninvasive positive - pressure mechanical ventilation （NIPPMV）, and another 18 patients in therapy group were treated with the conventional treatment and ulinastatin（UTI）. CD4＋ , CD8 ＋, CD4 ＋/CD8＋, NK were analyzed before and after the treatment. Results After the therapy, CD4＋ and NK had statistical differences （ P 〈 0. 05 ）. There was statistical difference in CD4＋ ,CD4＋/CD8＋ and NK（ P 〈0. 05 ） ,but there was not statistical difference in CD8＋（ P 〉 0.05） between the two groups. Conclusion Immunity decreases in the patients of acute left heart failure, especially CD4 ＋ , CD4 ＋/CD8＋. After using UTI, immunity functions are improved.

关 键 词：急性左心衰竭 细胞免疫 乌司他丁 

分 类 号：R285.5[医药卫生—中药学]