乌司他丁联合持续性肾脏替代治疗对严重脓毒症患者HMGB1及PTX3水平的影响  

Effect of ulinastatin combined with continuous renal replacement therapy on HMGB1 and PTX3 levels in patients with severe sepsis

作　　者：刘延媛[1] 刘汉冕[1] 陈杏波[1] LIU Yan-yuan(Department of intensive medicine, Huizhou central people ＇s hospital, ltuizhou , G uaugdong, 516001, China)

机构地区：[1]广东省惠州市中心人民医院重症医学科,516001

出　　处：《齐齐哈尔医学院学报》2018年第3期269-271,共3页Journal of Qiqihar Medical University

摘　　要：目的探讨乌司他丁联合持续性肾脏替代治疗对严重脓毒症患者HMGB1及PTX3水平的影响。方法选择2014年9月-2017年9月本院收治的90例严重脓毒症患者,按照简单随机法将患者分成观察组及对照组,各45例。对照组患者行CRRT治疗,观察组患者在此基础上联合乌司他丁治疗,观察两组患者的HMGB1、PTX3水平、淋巴细胞计数、外周血人白细胞DR抗原以及T淋巴细胞亚群水平。结果与治疗前相比,对照组及观察组治疗后的HMGB1及PTX-3逐渐降低,差异显著(F=20.233、22.162,18.490、19.450,P<0.05)。与对照组相比,观察组治疗第3 d、治疗第5 d的HMGB1及PTX-3明显更低,差异显著(t=3.041、5.532,9.827、6.111,P<0.05)。与治疗前相比,对照组及观察组治疗后的淋巴细胞计数、CD4^+T淋巴细胞、CD14^+单核细胞HLA-DR明显升高,差异显著(F=14.902、15.290、16.290、15.380,20.300、23.330、15.160、18.820,P<0.05)。与对照组相比,观察组治疗第5 d的淋巴细胞计数、CD4^+T淋巴细胞、CD14^+单核细胞HLA-DR明显更高,差异显著(t=3.111、5.314、8.400,P<0.05)。结论乌司他丁联合CRRT可有效降低严重脓毒症患者的HMGB1及PTX-3的表达水平,降低患者的炎症水平,改善预后。Objective To observe the effect of ulinastatin combined with continuous renal replacement therapy on HMGB1 and PTX3 levels in patients with severe sepsis. Methods 90 patients with severe sepsis admitted to our hospital from September 2014 to September 2017 were selected. The patients were divided into observation group and control group according to the simple random method,each group with 45 cases. Patients in the control group underwent CRRT,and patients in the observation group were treated with ulinastatin on this basis. The levels of HMGB1,PTX3,lymphocyte count,DR antigen and T lymphocyte subsets in peripheral blood were observed. Results Compared with those before treatment,HMGB1 and PTX-3 in control group and observation group decreased gradually(F = 20. 233,22. 162; 18. 490,19. 450,P〈0. 05）. Compared with the control group,HMGB1 and PTX-3 in the observation group were significantly lower on the 3 rd day and 5 days after treatment(t = 3.041,5.532; 9.827,6.111,P〈0.05）. Compared with those before treatment,the numbers of lymphocytes,CD4＋T lymphocytes and HLA-DR of CD14＋ monocytes in control group and observation group were significantly increased after treatment(F = 14.902,15.290,16.290,15.380,20.300,23.330,15.160,18.820,P〈0. 05）. Compared with the control group,the counts of lymphocytes on the 5 th day of treatment in the observation group were significantly higher in HLA-DR of CD4＋ T lymphocytes and CD14＋ monocytes(t = 3.111,5.314,8.400,P〈0.05）.Conclusions Ulinastatin combined with CRRT can effectively reduce the expression of HMGB1 and PTX-3 in patients with severe sepsis,reduce the level of inflammation in patients and improve the prognosis.

关 键 词：乌司他丁 持续性肾脏替代 严重脓毒症 高迁移率族蛋白1 穿透素-3 

分 类 号：R692[医药卫生—泌尿科学]