乌司他丁联合抗真菌药物治疗侵袭性念珠菌感染的实验研究  

Effects of Ulinastatin in treatment of invasive Candida infections

作　　者：李小悦[1] 黄顺伟[2] 陈娟[2] 江智毅[2] 管向东[2] 

机构地区：[1]东莞市人民医院ICU [2]中山大学附属第一医院SICU

出　　处：《中华普通外科学文献（电子版）》2013年第4期21-24,共4页Chinese Archives of General Surgery(Electronic Edition)

基　　金：广东省医学科研基金(A2010150);天普研究基金(01200909);中山大学学生业余科研基金(2010045)

摘　　要：目的探讨乌司他丁联合抗真菌药物治疗侵袭性念珠菌感染的有效性和可能机制。方法雄性昆明小鼠60只,经CTX预处理后腹腔注射白念珠菌混悬液,制作侵袭性念珠菌感染小鼠模型,随机分成对照组(n=20)、低剂量组(n=20)和高剂量组(n=20)。对照组给予抗真菌药物治疗,低剂量组给予抗真菌药物联合乌司他丁(1×104U/kg)治疗,高剂量组给予抗真菌药物联合乌司他丁(5×104U/kg)治疗,观察3组7 d生存率、肝组织细胞因子和血淋巴细胞亚群水平。结果侵袭性念珠菌感染小鼠模型制作成功。高剂量组第7天生存率显著高于对照组(70%vs30%,P=0.011)。低剂量组和高剂量组第7天肝组织IL-10均显著低于对照组(P<0.05)。低剂量组和高剂量组第7天小鼠CD4+/CD8+比例均显著高于对照组(P<0.05)。结论高剂量乌司他丁可以改善侵袭性念珠菌感染小鼠7 d生存率,机制可能与提高细胞免疫功能和降低免疫抑制的发生有关。Objective To investigate the effects and mechanism of Ulinastatin（UTI） combined with antifungal agents in treatment of invasive Candida infections （ICI）. Methods Sixty Kunming mice were randomly assigned to control group, low-dose group and high-dose group （20 in each group）. The model of ICI was reproduced by intraperitoneal injection of White monilial suspension after CTX pretreatment. Mice in control group were treated with antifungal agents. Mice in low-dose group and high-dose group were treated with UTI （1 x 104 U/kg or 5 x 104 U/kg） and antifungal agents. Survival rate, cytokine in liver tissue and blood lymphocyte subsets were compared among these groups. Results There was significant difference in survival rate between control group （30%） and high-dose group （70%）, P =0.011. There was no significant difference in survival rate between other groups. There were significant differences in IL-10 among three groups, P 〈 0.05. There were significant differences in CD3＋ rate, CD4＋ rate and CDS＋ rate between control group and high-dose group, P 〈 0.05. There were significant differences in CD4＋/CDS＋ rate among three groups, P 〈 0.05. Conclusion High-dose UTI can improve survival rate in mice with ICI through improving cellular immune and reducing immnnosuppression.

关 键 词：侵袭性念珠菌感染 乌司他丁 有效性 

分 类 号：R519[医药卫生—内科学]