参附注射液对严重创伤患者T细胞亚群、天然杀伤细胞及预后的影响  

The effect of Shenfu injection on T-lymphocyte subsets and natural killer cells and prognosis in severe trauma patients

作　　者：雷李美[1] 蓝翔[1] 考验[1] 郑浩[1] 

机构地区：[1]温州医科大学附属第六临床医院(丽水市人民医院)全科医学科,浙江丽水323000

出　　处：《中华全科医学》2016年第5期743-745,共3页Chinese Journal of General Practice

基　　金：浙江省丽水市公益性技术应用项目(2012ZC037)

摘　　要：目的探讨对严重创伤患者行参附注射液后外周血T细胞亚群和天然杀伤细胞(NK细胞)的变化,从而观察其对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对照组(30例)和参附治疗组(30例),同期选取30例健康体检者为健康对照组。对照组患者给予常规诊治,参附治疗组患者则在常规救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患者治疗前、治疗后3 d和7 d的外周血T细胞亚群的CD3^+、CD4^+、CD8^+和NK细胞的数量。并观察2组重症监护病房(ICU)治疗时间、MODS发生率及病死率。结果两治疗组CD3^+、CD4^+、CD8^+和NK细胞及CD4^+/CD8^+比值明显低于健康对照组(P<0.05)。治疗3 d,参附组CD3^+、CD4^+、CD8^+和NK细胞及CD4^+/CD8^+比值均明显升高(P<0.05)。治疗7 d,两治疗组CD3^+、CD4^+、CD8^+和NK细胞及CD4^+/CD8^+比值均明显升高(P<0.05)。参附组CD3^+、CD4^+、CD8^+和NK细胞及CD4^+/CD8^+比值明显高于对照组(P<0.05)。参附组ICU治疗时间、MODS发生率、病死率均明显低于对照组(P<0.05)。结论严重创伤患者在常规救治的基础上早期使用参附注射液,明显改善T细胞亚群和NK细胞的免疫障碍,从而缩短ICU住院时间,降低多器官功能障碍综合征发生率及病死率。Objective To investigate the effect of Shenfu injection on T-lymphocyte subsets and natural killer（NK） cells in severe trauma patients and the influence of ICU treatment time, multiple organ dysfunction syndrome （MODS） incidence rate and mortality. Methods Sixty severe trauma patients were divided into the control group （ n = 30） and shenfu group （n = 30）. Other 30 cases were chosen as health control group at the same phase. All patients were received conventional treatments ,however,the shenfu group patients were additionally received the shenfu injection treatment in the early stage. The T-lymphocyte subsets （CD3^＋ , CD4^＋ , CD8^＋ ） and NK cells were detected on 3rd and 7th day by flow cytometry. The ICU treatment time, MODS incidence rate and mortality were surveyed. Results Compared to health control group, the T-lymphocyte subsets and NK cell counts were significantly low in treatment groups before received treatment. On 3rd treatment day,the CD3^＋ , CD4^＋,CD8^＋ T-lymphocytes , NK cells and CD4^＋/CD8^＋ rate in shenfu group were significantly raised （P 〈 0.05 ）. On 7th treatment day, the CD3^＋ , CD4^＋ , CD8^＋ T-lymphocytes, NK cells and CD4^＋/CD8^＋ rate in shenfu and control group were significantly higher than health control group（P 〈0.05）. The ICU treatment time, MODS incidence rate and mortality in shenfu group were significantly lower than control group （P 〈 0.05 ）. Conclusion Base on conventional therapy, the early use of shenfu injection can significantly improve immune dysfunction of the T-lymphocyte subset and NK cell in severe trauma patients, so that the ICU treatment time, MODS incidence rate and mortality were reduced.

关 键 词：参附注射液 严重创伤 免疫障碍 MODS 

分 类 号：R641[医药卫生—外科学] R329.28[医药卫生—临床医学]