喜炎平注射液辅助奥司他韦对急性重症病毒感染性肺炎患者TLR4/NF-κB信号通路及下游炎症因子的影响  

Effects of Xiyanping injection combined with oseltamivir on TLR4/NF-κB signaling pathway and downstream inflammatory factors in patients with acute severe viral pneumonia

作　　者：莫伟良 吴森泉 黎银焕[1] 袁一帆 张平[1] MO Wei-liang;WU Sen-quan;LI Yin-huan;YUAN Yi-fan;ZHANG Ping(Dongguan People's Hospital,Dongguan,Guangdong 523000,China)

机构地区：[1]东莞市人民医院呼吸科,广东东莞523000

出　　处：《中华医院感染学杂志》2022年第19期2891-2895,共5页Chinese Journal of Nosocomiology

基　　金：广东省东莞市科技计划基金资助项目(2018507150011359)。

摘　　要：目的分析喜炎平注射液辅助奥司他韦对急性重症病毒感染性肺炎患者Toll样受体4/核因子-κB(TLR4/NF-κB)信号通路及下游炎症因子的影响。方法选取2019年2月-2021年2月东莞市人民医院急性重症病毒感染性肺炎患者82例,随机分为研究组(n=41)、对照组(n=41)。常规治疗基础上,对照组予以奥司他韦治疗,研究组予以喜炎平注射液辅助奥司他韦治疗,均治疗1周。比较两组临床疗效、症状缓解时间、不良反应、治疗前、治疗1周后全身炎症反应综合征(SIRS)评分、多器官功能障碍(MODS)评分、急性生理学和慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、血清TLR4、NF-κB及其下游炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、IL-8]、细胞免疫功能指标(CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+))水平。结果研究组疗效优于对照组(P=0.014)。研究组乏力缓解、退热、气促消失、憋喘消失、湿性啰音消失时间短于对照组(P<0.05)。研究组治疗1周后SIRS、MODS、APACHEⅡ评分均低于对照组(P<0.05)。研究组治疗1周后血清TLR4、NF-κB、TNF-α、IL-8、IL-6低于对照组(P<0.05)。研究组治疗1周后CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平均高于对照组(P<0.05)。两组不良反应差异无统计学意义(P=0.710)。结论喜炎平注射液辅助奥司他韦安全可靠,有助于增强急性重症病毒感染性肺炎患者机体抵抗力,缩短症状缓解时间,促进预后改善,其机制可能与抑制TLR4/NF-κB信号通路活化有关。OBJECTIVE To analyze the effect of Xiyanping injection combined with oseltamivir on Toll-like receptor 4/nuclear factor-κB(TLR4/NF-κB)signaling pathway and downstream inflammatory factors in patients with acute severe viral pneumonia.METHODS Totally 82 patients with acute severe viral pneumonia in Dongguan People’s Hospital from Feb.2019 to Feb.2021 were selected and randomly divided into the study group(n=41)and the control group(n=41).On the basis of conventional treatment,the control group was given oseltamivir treatment,and the study group was given Xiyanping injection assisted oseltamivir treatment,both for 1 week.The clinical efficacy,symptom relief time,adverse reactions,systemic inflammatory response syndrome(SIRS)score,multiple organ dysfunction(MODS)score,acute physiology and chronic health status scoring system II(APACHE II)before and after 1 week of treatment were compared between the two groups)score,serum TLR4,NF-κB and its downstream inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),IL-8],cellular immune function indicators(CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+))levels.RESULTS The curative effect of the study group was better than that of the control group(P=0.014).The time of fatigue relief,fever reduction,shortness of breath,wheezing and moist rales disappeared in the study group was shorter than that in the control group(P<0.05).The SIRS,MODS and APACHE II scores in the study group were lower than those in the control group after 1 week of treatment(P<0.05).After 1 week of treatment,serum TLR4,NF-κB,TNF-α,IL-8 and IL-6 in the study group were lower than those in the control group(P<0.05).After 1 week of treatment,the levels of CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)in the study group were higher than those in the control group(P<0.05).There was no significant difference in adverse reactions between the two groups(P=0.710).CONCLUSION Xiyanping injection adjuvant oseltamivir is safe and reliable,helps to enhance the body resistance of patients with a

关 键 词：Toll样受体4/核因子-κB信号通路 喜炎平注射液 奥司他韦 急性重症病毒感染性肺炎 免疫功能 

分 类 号：R563.1[医药卫生—呼吸系统]