痰热清联合抗生素治疗对重型颅脑损伤气管切开并发肺部感染患者血清IL-13、LTB_4的影响  

Expression of IL-13 and LTB_4 in patients with severe traumatic brain injury under treatment of Chinese medicine Tanreqing with antibiotics for pulmonary infection after tracheostomy

作　　者：田勇[1] 杜杭根[1] 范成普 王承[1] 何民[1] 章国军[1] 陈立[1] 郝必烈[1] 李宏宇[1] 

机构地区：[1]浙江中医药大学附属第二医院神经外科,杭州310005

出　　处：《浙江医学》2015年第8期658-660,共3页Zhejiang Medical Journal

基　　金：浙江省中医药管理局项目(2012ZA062)

摘　　要：目的探讨痰热清联合抗生素治疗对重型颅脑损伤气管切开并发肺部感染患者血清IL-13、白三烯B_4(LTB_4)水平的影响及临床意义。方法重型颅脑损伤行气管切开术后并发肺部感染患者80例,根据治疗方式分为痰热清联合抗生素治疗组(观察组)40例和单用抗生素治疗组(对照组)40例,两组疗程均为14d。治疗第1、3,7、14天测量两组患者的体温,行血常规检查了解患者血白细胞计数情况,并以酶联免疫吸附实验(ELISA)检测两组患者血清中IL-13及LTB_4水平。结果与对照组相比,观察组患者的IL-13水平在第1、3、7、14天均明显增高,而LTB_4则均明显减低(均P<0.01),观察组内不同时间点比较,均有统计学差异(均P<0.05)。治疗后第3、7、14天观察组患者的体温和治疗后第1、3、7、14天的血白细胞计数均较对照组明显降低(均P<0.01),而观察组内不同时间点比较,均有统计学差异(均P<0.05)。结论痰热清联合抗生素治疗可明显降低重型颅脑损伤气管切开并发肺部感染患者血清LTB_4水平,同时维持IL-13在较高水平,表明其可减轻患者肺部感染后的炎症反应。Objective To investigate the expression of under treatment of Chinese medicine Tanreqing with antibiotics L-13 and LTB4 in patients with severe traumatic brain injury for pulmonary infection after tracheostomy. Methods Eighty patients with severe craniocerebral injury underwent tracheotomy and complicated with pulmonary infection. Among them 40 pa- tients were treated with a combination of Tanreqing and antibiotics（observation group）, another 40 patients were treated with an- tibiotics alone （control group）, the treatment lasted for 14d in both groups. The expression of IL-13, LTB4, body temperature and white cell count （WBC） were measured regularly and compared between two groups. Results Compared to control group, the IL-13 in observation group were significantly higher on d 1, 3, 7 and 14（P〈0.01）, while LTB4 were significantly lower correspond- ingly（P〈：O.01）. The temperature and WBC in observation group were lower when compared with those in control group（P〈0.01）. There were statistical differences in temperature and WBC levels at different time points in observation group （P〈0.05）. Conclu- sion Chinese medicine Tanreqing with antibiotic therapy can reduce the LTB4 level and elevate the IL-13 level in severe trau- matic brain injury patients with pulmonary infection after tracheostomy, indicating the inhibition of inflammatory response of pul- monary infection.

关 键 词：痰热清 肺部感染 气管切开 颅脑损伤 IL-13 LTB. 

分 类 号：R563.1[医药卫生—呼吸系统] R651.15[医药卫生—内科学]