参附注射液对严重创伤患者T细胞亚群和天然杀伤细胞的影响  

Effect of Shenfu injection on T-lymphocyte subset and natural killer cell in severe trauma patients

作　　者：雷李美[1] 蓝翔[1] 郑浩[1] 

机构地区：[1]温州医科大学附属第六医院,丽水市人民医院全科医学科,浙江丽水323000

出　　处：《全科医学临床与教育》2016年第2期140-143,共4页Clinical Education of General Practice

基　　金：2012年度丽水市公益性技术应用项目(2012ZC037)

摘　　要：目的探讨参附注射液对外周血T细胞亚群和天然杀伤细胞(NK细胞)变化,从而观察其对严重创伤患者的重症监护室(ICU)治疗时间、多器官功能障碍综合征(MODS)发生率及病死率的影响。方法将60例严重创伤患者随机分为参附治疗组(30例)和常规治疗组(30例),同期选取30例健康体检者为对照组。常规治疗组患者给予常规诊治,参附治疗组患者则在常规诊治的基础上早期加用参附注射液治疗。采用流式细胞技术测定对照组患者体检时和另两组患者治疗前、治疗后第3天和第7天的外周血T细胞亚群的CD^(3+)、CD^(4+)、CD^(8+)和NK细胞的数量。并观察两组ICU治疗时间、MODS发生率及病死率。结果参附组治疗前、对照组治疗前、对照组三组CD^(3+)、CD^(4+)、CD^(8+)、CD^(4+)/CD^(8+)、NK比较,差异均有统计学意义(F分别=5.16、6.11、6.13、3.43、7.21,P均<0.05),进一步比较发现,参附组治疗前和常规治疗组治疗前CD^(3+)、CD^(4+)、CD^(8+)、CD^(4+)/CD^(8+)、NK均明显低于对照组(q分别=5.01、7.12、6.11、3.03、8.33、6.71、6.95、5.76、4.93、9.07,P均<0.05)。参附组治疗后第3天、治疗后第7天CD^(3+)、CD^(4+)、CD^(8+)、NK与治疗前比较,差异均有统计学意义(q分别=4.21、6.17、5.31、3.73、6.71、5.98、7.30、7.92,P均<0.05);常规治疗组治疗后第7天CD^(3+)、CD^(4+)、CD^(8+)、CD^(4+)/CD^(8+)、NK均明显高于治疗前(q分别=9.71、8.92、7.91、2.99、8.63,P均<0.05),而治疗后第3天CD^(3+)、CD^(4+)、CD^(8+)、CD^(4+)/CD^(8+)、NK与治疗前比较,差异无统计学意义(q分别=0.71、0.94、0.37、0.03、0.33,P均>0.05)。与常规治疗组治疗后第7天比较,参附组患者治疗后第7天CD^(3+)、CD^(4+)、CD^(8+)、NK明显升高(t分别=2.33、2.17、2.01、2.73,P均<0.05)。参附组ICU治疗时间、MODS发生率、病死率均明显低于常规治疗组(t=7.73,χ~2分别=11.21、1.53,P均<0.05)。结论严重创伤患者早期使用参附注射液,能�Objective To investigate the effect of Shenfu injection on T-lymphocyte subset and natural killer（NK） cell in severe trauma patients, thus to observe the influence on ICU treatment time, multiple organ dysfunction syndrome（MODS） incidence rate and mortality. Methods A total of 60 patients with severe trauma were divided into the Shenfu group（n=30） and conventional treatment group（n=30）. Other 30 healthy cases were chosen as control group at the same phase. The conventional treatment group was received conventional treatments, the Shenfu group patients were additionally received the Shenfu injection treatment in the early stage based on conventional treatment. The T-lymphocyte subset（CD^（3＋）,CD^（4＋）,CD^（8＋）） and NK cell were detected on 3^（rd） and 7^（th） day by flow cytometry. The ICU treatment time, MODS incidence rate and mortality were observed. Results The CD^（3＋）,CD^（4＋）,CD^（8＋）,CD^（4＋）/CD^（8＋）and NK were significantly different before treatmentin Shenfu group, conventional treatment group and control groups（F=5.16, 6.11, 6.13, 3.43, 7.21,P〈0.05）.The CD^（3＋）,CD^（4＋）,CD^（8＋）,CD^（4＋）/CD^（8＋） and NK cells counts were significantly low in Shenfu group and conventional treatment group before received treatment than control group（q=5.01, 7.12, 6.11,3.03, 8.33, 6.71, 6.95, 5.76, 4.93, 9.07, P〈0.05）. On 3^（rd） and 7^（th） day after treatment, the CD^（3＋）,CD^（4＋）,CD^（8＋） and NK in Shenfu group were significantly raised（q =4.21, 6.17, 5.31, 3.73, 6.71, 5.98, 7.30, 7.92, P 0.05）. On 7^（th） day after treatment, the CD^（3＋）, CD^（4＋）, CD^（8＋）, CD^（4＋）/CD^（8＋）and NK in conventional treatment group were significantly raised（q=9.71,8.92, 7.91, 2.99, 8.63, P 0.05）, and it was no significantly different between the 3^（th） day after treatment and before treatment（q=0.71, 0.94, 0.37, 0.03, 0.33, P〉0.05）. On 7^（th） day after treatment,

关 键 词：参附注射液 严重创伤 免疫障碍 多器官功能障碍综合征 

分 类 号：R285.6[医药卫生—中药学]