乌司他丁在体外膜肺氧合治疗中的免疫调节作用  

Effect of Ulinastatin on Immune Regulation in Extracorporeal Membrane Oxygenation

作　　者：郭伟光[1] 温伟标[1] 强新华[1] 余志辉[1] 周立新[1] GUO Wei-guang;WEN Wei-biao;QIANG Xin-hua;YU Zhi-hui;ZHOULi-xin(Department of Critical Care Medicine,Foshan First People's Hospital,Foshan 528000)

机构地区：[1]广东省佛山市第一人民医院重症医学科

出　　处：《岭南急诊医学杂志》2019年第6期533-535,563,共4页Lingnan Journal of Emergency Medicine

摘　　要：目的:探讨乌司他丁在体外膜肺氧合治疗中的免疫调节作用。方法:回顾性分析2010年至2017年我科行ECMO的患者,按是否应用乌司他丁分为治疗组和对照组。结果:14例ECMO患者(治疗组10例,对照组4例),治疗组第7、14天人类白细胞抗原(HLA-DR)、辅助性T淋巴细胞(T-CD4^+)均显著升高,且第14天显著高于对照组(P<0.05),两组抑制性T淋巴细胞(T-CD8^+)、白细胞计数、降钙素原较前无统计学差异,但对照组第14天白细胞高于治疗组。治疗组院感发生率低于对照组(33.6‰vs 57.9‰,P<0.05),且发生时间晚于对照组[(11.9±1.8)天vs(7.2±2.1)天,P<0.05]。结论:乌司他丁在ECMO治疗中有助于改善患者免疫功能,减少院感发生率,有助于改善预后。Objective:To study the effect of ulinastatin on immune regulation in extracorporeal membrane oxygenation(ECMO).Methods:A retrospective analysis of patients with ECMO-assisted treatment in the ICU of Foshan First People's Hospital from January 2010 to December 2017 were conducted.Patients were divided into treatment group and control group according to receiving ulinastatin treatment or not.Results:A total of 14 patients with ECMO were enrolled,including 10 in the treatment group and 4 in the control group.The treatment group showed significant increase in human leukocyte antigen(HLA-DR)and helper T lymphocytes(T-CD4^+)on the 7th and 14th day(P<0.05).There were no statistical differences in suppressive T lymphocytes(T-CD8^+),white blood cell count,and procalcitonin between two groups,but the white blood cells in the control group were higher than the treatment group on the 14th day.Hospital-acquired infection in the treatment group appeared later than in the control group[(11.9±1.8)days and(7.2±2.1)days,P<O.05],and the incidence of which in the treatment group was lower than in the control group(33.6‰vs 57.9‰,P<0.05).Conclusion:Ulinastatin shows positive effect on immune regulation and can reduce the incidence of hospital-acquired infection and improve prognosis during ECMO treatment.

关 键 词：体外膜肺氧合 乌司他丁 免疫调节 院内获得性感染 

分 类 号：R459.7[医药卫生—急诊医学]