脓毒症患者联合使用前列腺素E_1的疗效及对促炎及抗炎因子水平的影响  

Effects of combined use of prostaglandin E_1 on ICU patients with sepsis and its effects on proinflammatory and antiinflammatory cytokines levels

作　　者：蔡金亮[1] 谢文杰[1] 罗建芬[1] 余庆华 黄裕鹏 王美力[1] Cai Jinliang;Xie Wenjie;Luo Jianfen;Yu Qinghua;Huang Yupeng;Wang Meili(Department of ICU,Gaoming District People＇s Hospital,Foshan 528500,China)

机构地区：[1]广东省佛山市高明区人民医院ICU,528500

出　　处：《山西医药杂志》2018年第10期1134-1137,共4页Shanxi Medical Journal

摘　　要：目的探讨脓毒症采用前列腺E1与血必净联合治疗的临床效果及对促炎及抗炎因子水平的影响。方法选取136例入住我院重症监护病房(ICU)的脓毒症患者,随机分为Ⅰ、Ⅱ、Ⅲ和对照组,每组34例,Ⅰ、Ⅱ、Ⅲ组分别给予前列腺素E1+血必净、前列腺素E1、血必净治疗,对照组除基础治疗外不做任何处理。对比4组患者治疗前后急性生理和慢性健康状况评分Ⅱ(APACHEⅡ)和Marshall评分变化、促炎及抗炎因子水平变化。对比4组患者机械通气时间、ICU住院时间、28d病死率及治疗期间出现的不良反应情况。结果 4组患者治疗后的APACHEⅡ评分和Marshall评分与治疗前比较明显较低(P<0.05)。Ⅰ组、Ⅱ组、Ⅲ组治疗后的APACHEⅡ评分和Marshall评分与对照组比较明显较低(P<0.05),Ⅰ组降低程度更为明显(P<0.05)。与对照组比较,Ⅰ组、Ⅱ组、Ⅲ组白细胞介素(IL)-1β、IL-6、肿瘤坏死因子(TNF)-α水平明显较低(P<0.05)。与对照组比较,Ⅰ组、Ⅱ组IL-10水平明显较高(P<0.05)。与Ⅱ组、Ⅲ组比较,Ⅰ组IL-1β、IL-6、TNF-α水平明显较低,IL-10水平明显较高,差异有统计学意义(P<0.05)。与对照组比较,Ⅰ组、Ⅱ组、Ⅲ组机械通气时间、ICU住院时间明显较少,28d病死率明显较低,差异有统计学意义(P<0.05)。与Ⅱ组、Ⅲ组比较,Ⅰ组机械通气时间、ICU住院时间明显较少,差异有统计学意义(P<0.05)。4组患者在治疗期间均未出现严重不良反应。结论脓毒症采用前列腺E1与血必净联合治疗的临床效果较好,能抑制体内炎症反应,缩短住院时间,加快患者恢复,降低病死率。Objective To investigate the clinical effect of prostaglandin E1 combined with Xuebijing in the treatment of sepsis,as well as its effects on the levels of proinflammatory and anti-inflammatory cytokines.Methods One hundred and thirty-six sepsis patients who were treated in the ICU of our hospital were selected and randomly divided intoⅠ group,Ⅱ group,Ⅲ group and control group,34 cases in each group.The patients in theⅠgroup,Ⅱ group andⅢ group were treated with prostaglandin E1＋Xuebijing,prostaglandin E1 and Xuebijing,respectively,and the patients in the control group received no other treatment except basic treatment.The APACHE score and Marshall score changes,and the changes of proinflammatory and anti-inflammatory cytokines levels of four groups were compared.The mechanical ventilation time,ICU stay,28-day mortality and incidence of adverse reactions during treatment of four groups were compared.Results The APACHE Ⅱscore and Marshall score of patients in four groups after treatment were significantly lower than those before treatment（P 〈0.05）.The APACHE Ⅱ score and Marshall score in Ⅰ,Ⅱ and Ⅲ groups after treatment were significantly lower than those in the control group（P 〈0.05）,and the decreasing in theⅠ group was more significant（P 〈0.05）.The IL-1β,IL-6 and TNF-αlevels in Ⅰ,Ⅱ and Ⅲ groups were lower than those in the control group（P 〈0.05）.The IL-10 level in theⅠ and Ⅱ groups was higher than that in the control group（P 〈0.05）.The IL-1β,IL-6 and TNF-αlevels in the I group were lower than those in theⅡ and Ⅲ groups,while the IL-10 level was higher than Ⅱ and Ⅲ group,and the differences were statistically significant（P 〈0.05）.The mechanical ventilation time,ICU stay and 28-day mortality in theⅠ,Ⅱ andⅢ group were significantly lower than those in the control group,and the differences were statistically significant（P 〈0.05）.Compared with Ⅱ and Ⅲ group,the mechanical ventilation time and ICU stay were lower in the�

关 键 词：前列腺E1 血必净 脓毒症 白细胞介素1Β 白细胞介素6 白细胞介素10 肿瘤坏死因子α 

分 类 号：R459.7[医药卫生—急诊医学]