乌司他丁与血必净联合应用对感染性休克患者血流动力学、血清炎症因子及免疫功能的影响  

Effect of Ulinastatin Combined with Xuebijing on Hemodynamics,Serum Inflammatory Factors and Immune Function in Patients with Septic Shock

作　　者：徐瑞华[1] 张娆娆[1] Xu Ruihua;Zhang Raorao(Department of Intensive Care,The Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第五附属医院重症医学科,郑州450000

出　　处：《成都医学院学报》2018年第6期705-709,共5页Journal of Chengdu Medical College

基　　金：河南省卫生厅科研项目(No:B2016-12509)

摘　　要：目的探讨乌司他丁与血必净联合应用对感染性休克患者血流动力学、血清炎症因子及免疫功能的影响。方法采用回顾性病例对照研究方法,选取2011年1月至2017年12月郑州大学第五附属医院重症医学科病房收治的135例感染性休克患者作为研究对象,根据治疗方法不同分为治疗组(n=75)和对照组(n=60)。在常规治疗基础上,对照组给予血必净连续治疗7d;在对照组基础上,治疗组给予乌司他丁连续治疗7d。治疗前后比较两组血流动力学、血清炎症因子及免疫功能指标变化情况。结果与治疗前相比,治疗后所有患者心率(HR)明显下降,平均动脉压(MAP)、氧合指数(PO2/FIO2)明显升高,血清白细胞介素(IL)-6、IL-8、肿瘤坏死因子(TNF)-α明显降低,T淋巴亚群CD3+、CD4+、CD4+/CD8+细胞水平明显升高,NK细胞明显降低,差异有统计学意义(P<0.05)。治疗组治疗后血流动力学指标(HR、MAP、PO2/FIO2),血清炎症因子(IL-6、IL-8、TNF-α)及免疫功能指标(CD3+、CD4+、CD4+/CD8+、NK细胞)改善效果较对照组治疗后更明显,差异有统计学意义(P<0.05)。同时,治疗组治疗后脓毒症相关性器官功能衰竭评分(SOFA)及急性生理与慢性健康状况(APACHE II)评分明显低于对照组(P<0.05)。结论乌司他丁与血必净联合应用可有效促使感染性休克患者血流动力学稳定,缓解全身炎症反应,提高机体免疫功能。Objective To investigate the effect of Ulinastatin combined with Xuebijing on hemodynamics,serum inflammatory factors and immune function in patients with sepsis shock.Methods A retrospective case-control study was conducted.135patients with septic shock admitted to The Fifth Affiliated Hospital of Zhengzhou University from January of2011to December of2017were selected as the research objects and divided into the treatment group(n=75)and the control group(n=60)according to the different treatment Methods.On the basis of the conventional treatment,the control group was treated with Xuebijing for7days while the treatment group was treated with Ulinastatin combined with Xuebijing for7days.The two groups were compared in the changes of the indexes including hemodynamics,serum inflammatory factors and immune function before and after treatment.Results Compared with before treatment,the heart rate(HR),serum interleukin(IL)-6,IL-8,tumor necrosis factor(TNF-α)and NK cells in all patients were significantly decreased(P<0.05)and the mean arterial pressure(MAP),oxygenation index(PO2/FIO2),levels of the T lymphocyte subsets CD3+,CD4+and CD4+/CD8+were significantly increased after treatment(P<0.05).The improvement of the hemodynamic parameters including HR,MAP and PO2/FIO2,the serum inflammatory factors including IL-6,IL-8and TNF-α,and the immune function indicators including CD3+,CD4+,CD4+/CD8+and NK cells after treatment was more significant in the treatment group than in the control group(P<0.05).The scores of sepsis-associated organ failure(SOFA)and acute physical and chronic health evaluation(APACHEⅡ)after treatment in the treatment group were significantly lower than those in the control group(P<0.05).Conclusion Ulinastatin combined with Xuebijing can effectively improve the hemodynamic stability,relieve the systemic inflammatory response,and ameliorate the immune function in patients with septic shock.

关 键 词：乌司他丁 血必净 感染性休克 血流动力学 炎症因子 免疫功能 

分 类 号：R453[医药卫生—治疗学]