胸腺肽α1对脓毒症患者T淋巴细胞及TLR9信号通路的影响  

Effect of thymosinα1 on T lymphocytes and TLR9 signaling pathway in patients with sepsis

作　　者：李远思[1] 程玲[1] 张琦[2,3] 聂卫群 林燕林[1] LI Yuan-si;CHENG Ling;ZHANG Qi;NIE Wei-qun;LIN Yan-lin(Department of Intensive Medicine,the First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei,Anhui 230031,China;不详)

机构地区：[1]安徽中医药大学第一附属医院重症医学科,安徽合肥230031 [2]安徽中医药大学第一附属医院普外科 [3]安徽省中医药科学院外科研究所,安徽合肥230031

出　　处：《中华全科医学》2021年第9期1470-1473,共4页Chinese Journal of General Practice

基　　金：安徽省高校优秀青年人才支持计划项目(gxyq2019035)。

摘　　要：目的通过观察胸腺肽α1治疗脓毒症患者免疫等指标的变化,为其治疗脓毒症提供依据。方法选取2017年1月—2020年8月期间安徽中医药大学第一附属医院ICU收治的50例脓毒症患者,按照随机数字表法分为对照组和观察组,各25例。对照组给予抗感染、改善脏器功能等常规综合治疗,观察组在对照组治疗的基础上加用胸腺肽α1治疗,疗程为7 d。分别观察2组患者治疗前后CD3^(+)、CD8^(+)、CD4^(+)/CD8^(+)比值等T细胞指标;降钙素原(PCT)、C反应蛋白(CRP)水平和TLR9信号通路中Toll样受体9(TLR9)、核因子KB(NF-κB)蛋白表达等炎症指标;序贯器官功能衰竭评估(SOFA)和急性生理与慢性健康状况评估Ⅱ(APACHEⅡ)评分等病情严重程度指标。结果观察组治疗后CD3^(+)上升、CD8^(+)下降、CD4^(+)/CD8^(+)比值上升,与对照组治疗后相比,差异有统计学意义(t=4.874、3.864、2.162,均P<0.05)。观察组治疗后,患者PCT、CRP水平和TLR9、NF-κB蛋白表达水平明显低于对照组(t=4.833、7.081、5.871、8.361,均P<0.05)。观察组治疗后SOFA和APACHEⅡ评分均下降,下降程度明显低于对照组(t=3.672、5.354,均P<0.05)。结论胸腺肽α1可很好地调节脓毒症患者的免疫功能,减轻脓毒症的炎症反应。Objective To observe the effects of thymosinα1 on changes in indicators such as immunity in patients with sepsis,and to seek evidence-based evidence for its application in the treatment of sepsis.Methods According to the random number table,50 patients with sepsis admitted to the ICU of the First Affiliated Hospital of Anhui University of Chinese Medicine from January 2017 to August 2020 were divided into control group and observation group with 25 cases in each group.Patients in the control group were given conventional comprehensive treatments such as anti-infection,improvement of organ function for 7 days.Patients in the observation group were treated with thymosinα1 on the basis of the conventional comprehensive treatments for 7 days.The T cell indicators such as the T cell subsets CD3^(+),CD8^(+),CD4^(+)/CD8^(+)ratio before and after treatment in the two groups,inflammation indicators procalcitonin(PCT),C reactive protein(CRP)levels and TLR9,NF-κB protein expression in the TLR9 signaling pathway,disease severity indicators sequential organ failure assessment(SOFA)score and acute Physiology and chronic health evaluation(APACHEⅡ)score were observed.Results After treatment in the observation group,CD3^(+)increased,CD8^(+)decreased,and CD4^(+)/CD8^(+)ratio increased.Compared with the control group,the difference was statistically significant(t=4.874,3.864,2.162,all P<0.05).Compared with the control group,the inflammatory index PCT,CRP levels and the TLR9 and NF-KB protein expression levels in the observation group were significantly lower than those in the control group(t=4.833,7.081,5.871,8.361,all P<0.05).The disease severity indicators SOFA score and APACHEⅡscore decreased significantly.The SOFA score and APACHEⅡscore of the observation group decreased after treatment,and the degree of decline was significantly lower than that of the control group(t=3.672,5.354,all P<0.05).Conclusion Thymosinα1 can well regulate the immune function of patients with sepsis and reduce the inflammatory response of seps

关 键 词：胸腺肽Α1 脓毒症 T细胞亚群 TOLL样受体9 免疫功能 

分 类 号：R63[医药卫生—外科学] R331.144[医药卫生—临床医学]