乌司他丁联合常规治疗对重症肺炎患者免疫功能及TLR2/4表达的影响  

Effect of Ulinastatin Combined Conventional Therapy on Immunity Function and Expression of TLR2/4 in Patients with Severe Pneumonia

作　　者：余露娟 叶晓林[2] YU Lu-juan;YE Xiao-lin(Department of Pharmacy,Second People′s Hospital of Jiangyou City,Jiangyou 621701,China;Department of Pharmacology,Chengdu University of Traditional Chinese Medicine,Chengdu 610075,China)

机构地区：[1]江油市第二人民医院药剂科,四川江油621701 [2]成都中医药大学药理教研室,四川成都610075

出　　处：《标记免疫分析与临床》2019年第1期111-115,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探究乌司他丁联合常规治疗对重症肺炎患者免疫功能及TLR2、TLR4表达的影响。方法选取2015年8月至2016年10月收入我院的164例重症肺炎患者,依据随机数字表法分为对照组和观察组,每组患者82例。对照组给予常规治疗,观察组在对照组基础上给予乌司他丁治疗。比较2组患者治疗前后呼吸功能、APACHEⅡ评分、免疫功能及TLR2、TLR4表达情况。结果治疗3、7d后,观察组患者P(O_2)显著高于对照组(P<0.05),而P(A-a)O_2、P(O_2)/FiO_2、呼吸频率显著低于对照组,差异具有统计学意义(P <0.05)。治疗7d后,观察组的APACHE-Ⅱ评分显著优于对照组(P <0.05)。治疗后,观察组CD3^+、CD4^+、CD4^+/CD8^+显著高于对照组,差异具有统计学意义(P <0. 05),而两组CD8^+比较差异无统计学意义(P>0.05)。治疗后,两组患者的TLR2/4 mRNA及TLR2/4rMFI表达相比于治疗前均显著下调(P <0.05),且观察组下调程度大于对照组,差异具有统计学意义(P <0.05)。结论乌司他丁联合常规治疗可显著改善重症肺炎患者呼吸功能和免疫功能,降低TLR2/4的表达。Objective To explore the effect of ulinastatin combined conventional therapy on immunity function and expression of TLR2/4 in patients with severe pneumonia. Methods 164 patients with severe pneumonia treated in our hospital from August 2015 to October 2016 were randomly divided into control group and observation group,with 82 cases in each group.Control group was treated with routine treatment,andobservation group was treated with routine treatment combined with ulinastatin.The respiratory function,APACHE II score,immune function and TLR2,TLR 4 expression were compared between these 2 groups before and after treatment. Results 3,7 days after treatment,the P (O2)in observation group was significantly higher than that in control group ( P <0.05),while P (A- a)O2,P(O 2)/FiO2,respiratory rate was significantly lower than that of control group.The difference was statistically significant ( P <0.05).After treatment with 7d,the APACHE- score of observation group was significantly better than that of control group ( P < 0.05).After treatment,the CD3 ^+,CD4 ^+,CD4 ^+/CD8 ^+ of observation group was significantly higher than that of control group,the difference was statistically significant ( P <0.05),but there was no significant difference of CD8 ^+ between the two groups ( P >0.05).After treatment,the expression of TLR2/4 mRNA and TLR2/4rMFI in the two groups were significantly lower than that before treatment ( P <0.05),those in observation group was significantly lower thanthose in control group,and the difference was statistically significant ( P <0.05). Conclusion Ulinastatin combined with routine treatment can effectively improve respiratory function,immune function and down- regulation of TLR2/4 expression.

关 键 词：乌司他丁 重症肺炎 免疫功能 TOLL样受体 

分 类 号：R563.1[医药卫生—呼吸系统]