黄芪注射液治疗脓毒症患者前后免疫细胞及细胞因子水平变化  

Changes of immune Cells and Cytokines Before and After Astragalus Injection Treatment of Patients with Sepsis

作　　者：侯静静[1] 徐慕娟[1] 黄俊城 阮俊[1] HOU Jingjing;XU Mujuan;HUANG Juncheng;RUAN Jun(Shenzhen Hospital of Traditional Chinese Medicine,Shenzhen 518033,Guangdong,China;Longchuan County Hospital of TCM,Shenzhen 517300,Guandong,China)

机构地区：[1]深圳市中医院,广东深圳518033 [2]广东龙川县中医院,广东深圳517300

出　　处：《辽宁中医杂志》2018年第9期1876-1878,共3页Liaoning Journal of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(20172120)

摘　　要：目的：探讨黄芪注射液治疗脓毒症患者前后免疫细胞及细胞因子水平变化。方法：随机选取2017年3月—2018年3月本院收治的脓毒症患者50例,依据治疗方法将这些患者分为常规治疗组（n=25）和常规治疗联合黄芪注射液治疗组（联合治疗组,n=25）两组,统计分析两组患者的免疫细胞、细胞因子、心功能、APACHEⅡ评分、SOFA评分机械通气时间、住ICU时间、不良反应发生情况及心肌抑制发生情况、28 d病死情况。结果：联合治疗组患者的CD4、CD4/CD8、NK均显著高于常规治疗组（P〈0.05）,CD8显著低于常规治疗组（P〈0.05）,血清IL-6、IL-1β、TNF-α水平均显著低于常规治疗组（P〈0.05）,LVESD、LVEDD均显著低于常规治疗组（P〈0.05）,LVEF显著高于常规治疗组（P〈0.05）,有创通气时间、无创通气时间、住ICU时间均显著短于常规治疗组（P〈0.05）,但两组患者的APACHEⅡ评分、SOFA评分之间的差异均不显著（P〉0.05）。两组患者的不良反应发生率、心肌抑制发生率、28 d病死率8.0%（2/25）、56.0%（14/25）、16.0%（4/25）vs 4.0%（1/25）、52.0%（13/25）、20.0%（5/25）之间的差异均不显著（P〉0.05）。结论：黄芪注射液治疗脓毒症能够有效调整患者免疫失衡,减轻患者炎症反应。Objective： To investigate the changes of immune cells and cytokines before and after Astragalus Injection treatment of patients with sepsis. Methods： Fifty cases of patients with sepsis from March 2017 to March 2018 in our hospital were randomly selected. These patients were divided into two groups according to conventional treatment group（n = 25） and conventional therapy combined with Astragalus Injection treatment group（combined treatment group,n = 25）. The immune cells,cytokines,cardiac functions,PACHE II scores,SOFA scores,mechanical ventilation time,ICU duration,adverse reactions,myocardial inhibition and28 d mortality of the two groups were statistically analyzed. Results： The CD4,CD4/CD8 and NK of the combined treatment group were significantly higher（P〈0. 05）,and the CD8 was significantly lower（P〈0. 05）. The serum IL-6,IL-1 β and TNF-αlevels were significantly lower（P〈0. 05）. The LVESD and LVEDD were significantly lower（P〈0. 05）. The duration of invasive ventilation,non invasive ventilation and ICU time were significantly shorter than those of the conventional treatment group（P〈0. 05）,but the differences of APACHE II scores and SOFA scores between the two groups were not significant（P〉0. 05）. The difference of incidences of adverse reactions,myocardial inhibition,28 d mortality 8. 0%（2/25）,56. 0%（14/25）,16. 0%（4/25） vs 4. 0%（1/25）,52. 0%（13/25）,20. 0%（5/25） between the two groups were not significant（P〉0. 05）. Conclusion：Astragalus Injection can effectively adjust the immune imbalance and reduce the inflammatory reaction of patients with sepsis.

关 键 词：黄芪注射液 脓毒症 免疫细胞 细胞因子 

分 类 号：R631[医药卫生—外科学]