胸腺肽结合床旁高流量CBP治疗脓毒症患者对其血清HBP和HO-1及血流动力学参数的影响  

Effects of thymosin combined with bedside high flow CBP on serum HBP and HO-1 and hemodynamic parameters in patients with sepsis

作　　者：杜晓敏 戴科芳 张瑞英 胡小倩[2] DU Xiaomin;DAI Kefang;ZHANG Ruiying;HU Xiaoqian(Department of Critical Care Medicine,the Third Hospital of Xingtai,Xingtai,Hebei,054000,China;Department of Critical Care Medicine,People's Hospital of Xingtai)

机构地区：[1]邢台市第三医院重症医学科,河北邢台054000 [2]邢台市人民医院重症医学科

出　　处：《临床急诊杂志》2023年第8期399-403,共5页Journal of Clinical Emergency

基　　金：河北省医学科学研究课题项目(No:20201575);邢台市重点研发计划自筹项目(No:2020ZC314)。

摘　　要：目的探讨胸腺肽结合床旁高流量连续性血液净化(continuous blood purification,CBP)治疗脓毒症患者对其血清肝素结合蛋白(heparin binding protein,HBP)、血红素加氧酶-1(heme oxygenase-1,HO-1)及血流动力学参数的影响。方法选取2021年7月—2022年3月于邢台市第三医院收治的88例脓毒症患者,依据随机数表法将患者分为O组及C组,44例C组患者给予床旁高流量CBP,在C组的基础上44例O组患者给予胸腺肽皮下注射,两组患者治疗2周后比较患者临床疗效、T细胞亚群、炎症因子、血清HBP、HO-1水平及血流动力学参数。结果O组患者的临床总有效率为88.64%(39/44),明显高于C组的临床总有效率(70.45%,31/44),两组差异有统计学意义(P<0.05)。与C组患者治疗后比较,O组患者的CD3+及CD4+水平更高,CD8+水平更低,两组差异有统计学意义(P<0.05)。O组患者的TNF-α及IL-6水平低于C组,两组差异有统计学意义(P<0.05)。O组患者治疗后,HBP水平低于C组,两组差异有统计学意义(P<0.05);HO-1水平和SVR水平均高于C组,两组差异有统计学意义(均P<0.05)。结论胸腺肽结合床旁高流量CBP有利于减轻脓毒症患者的炎症反应、对于机体免疫功能与血流动力学均具有积极的作用,有利于降低HBP水平的表达及提高HO-1水平的表达,具有确切的疗效。Objective To investigate the effects of thymosin combined with bedside high flow continuous blood purification(CBP)on serum heparin binding protein(HBP),heme oxygenase-1(HO-1)and hemodynamic parameters of septic patients treated with CBP.Methods Eighty-eight patients with sepsis admitted to the Third Hospital of Xingtai from July 2021 to March 2022 were selected and divided into Group O and Group C according to random number table method.Forty-four patients in group C were given high-flow bedside CBP,and 44 patients in group O were given subcutaneous injection of thymosin on the basis of group C.After 2 weeks of treatment,the clinical efficacy,T cell subsets,inflammatory factors,serum HBP,HO-1 levels and hemodynamic parameters of the patients were compared.Results The total clinical effective rate in observation group was 88.64%(39/44)higher than 70.45%(31/44)in control group,and the differences were statistically significant(P<0.05).Comparison with patients in the control group after treatment,the levels of CD3+and CD4+in observation group were higher,and the levels of CD8+were lower,and the differences were statistically significant(P<0.05).The levels of TNF-αand IL-6 in observation group were lower than control group,and the differences were statistically significant(P<0.05).HBP level in observation group was lower than control group after treatment,and the differences were statistically significant(P<0.05).And HO-1 level in observation group was higher than control group after treatment,and the differences were statistically significant(P<0.05).The SVR level of observation group was higher than control group after treatment,and the differences were statistically significant(P<0.05).Conclusion Thymosin combined with bedside high-flow CBP is beneficial to reduce the inflammatory response of sepsis patients,and has a positive effect on immune function and hemodynamics of the body.It is beneficial to reduce the expression of HBP level and increase the expression of HO-1 level,which has a definite curative effect

关 键 词：胸腺肽 高流量血液净化 脓毒症 肝素结合蛋白 血红素加氧酶-1 血流动力学 

分 类 号：R459.7[医药卫生—急诊医学]