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乌司他丁联合胸腺肽α_1对脓毒症患者免疫调理的合理性分析 被引量:12

Analysis on the immunoregulation of combined therapy of ulinastatin and thymosin α_1 in the treatment of sepsis
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摘要 目的探讨乌司他丁联合胸腺肽α1对脓毒症、多器官功能衰竭(MODS)免疫状态的影响,分析其在免疫调理中的合理性。方法46例脓毒症、18例MODS患者均随机分为对照组和治疗组。对照组给予SSC经典治疗,治疗组则给予乌司他丁联合胸腺肽α1免疫调理疗法,进入程序时及治疗结束时采用ELISA方法检测IL-6、IL-10含量。结果脓毒症治疗组IL-6、IL-10明显下降,与脓毒症对照组相比差异显著(P<0.05),进一步将仅给予SSC经典治疗的对照组分为存活亚组和死亡亚组,其中存活亚组IL-6、IL-10在后期均下降,与死亡亚组相比差异显著(P<0.05)。MODS治疗及对照组治疗前后IL-6、IL-10差异无显著性(P>0.05)。结论乌司他丁联合胸腺肽α1能够均衡下降脓毒症炎症/抗炎介质的水平,调整脓毒症免疫状态,但对MODS患者的免疫调理作用有待进一步观察。 Objective To observe the influences of combined therapy of ulinastatin and thymosin α1 on the immune state in the treatment of sepsis and multiple organ failure (MODS), and to evaluate the therapeutic rationality. Methods 46 patients with sepsis and 18 patients with MODS were randomly divided into two groups. The patients in control group were treated with classical SSC therapy, those in treatment group were treated with the combined ulinastatin and thymosin α1 therapy. The contents of IL-6 and IL-10 were detected with ELISA at the beginning of and after the treatment. Results After treatment, the concentrations of IL-6 and IL-10 declined significantly in treatment group, while no apparent changes were observed in the control group. There existed a significant difference between the two groups (P〈0. 05). To further analyze the survived and dead patients in control group, it was found that the levels of IL-6 and IL-10 decreased in survival subgroup during the late period, and there existed a significant difference compared with the death group (P〈0. 05). The therapeutic efficiency of the two therapies showed no significant difference on the treatment of MODS. Conclusion Combined ulinastatin and thymosin α1 therapy may modulate the release of cytokines and throw a positive influence on the immune state of sepsis patients. However, the effect of the combined therapy on the treatment of MODS is to be investigated.
出处 《解放军医学杂志》 CAS CSCD 北大核心 2007年第2期161-163,共3页 Medical Journal of Chinese People's Liberation Army
基金 广东省自然科学基金资助项目(05000139)
关键词 脓毒症 多器官功能衰竭 免疫调理 sepsis multiple organ failure immuno-recuperative function
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参考文献12

  • 1Dellinger RP,Carlet JM,Masur H,et al.Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock.Crit Care Med,2004,30(4):536
  • 2Bone RC.Sir Isaac Newton,sepsis,SIRS,and CARS.Crit Care Med,1996,24(7):1125
  • 3林洪远,盛志勇.脓毒症免疫调理治疗的新思路[J].中国危重病急救医学,2004,16(2):67-69. 被引量:85
  • 4Bone RC,Balk RA,Cerra FB,et al.Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis.The ACCP/SCCM Consensus Conference Committee.American College of Chest Physicians/Society of Critical Care Medicine.Chest,1992,101(6):1644
  • 5Munford RS,Pugin J.Normal responses to injury prevent systemic inflammation and can be immunosuppressive.Am J Respir Crit Care Med,2001,163:316
  • 6苏磊,周殿元,唐柚青,文强,白涛,孟繁苏,唐丽群,段鹏凯.CD14^+单核细胞人白细胞DR抗原在脓毒症早期检测中的临床意义[J].中国危重病急救医学,2006,18(11):677-679. 被引量:21
  • 7Heidecke CD,Hensler T.Selective defects of T lymphocyte function in patients with lethal intraabdominal infection.Am J Surg,1999,178:288
  • 8Annane D,Sebille V,Bellissant E,et al.Effect of low doses of corticosteroids in septic shock patients with or without early acute respiratory distress syndrome.Crit Care Med,2006,34(1)22
  • 9Frost RA,Lang CH.Skeletal muscle cytokine:regulation by pathogen-associated molecules and catabolic hormones.Curr Opin Clin Nutr Metab Care,2005,8:255
  • 10Lekkou A,Karakantza M,Mouzaki A,et al.Cytokine production and monocyte HLA-DR expression as predictors of outcome for patients with community-acquired severe infections.Clin Diagn Lab Immunol,2004,11(1):161

二级参考文献11

  • 1Angus D C,Linde-Zwirble,W T,Lidicker J,et al.Epidemiology of severe sepsis in the United States:analysis of incidence,outcome,and associated costs of care[J].Crit Care Med,2001,29:1303-1310.
  • 2Volk H D,Reinke P,Krausch D,et al.Monocyte deactivation:rationale for a new therapeutic strategy in sepsis[J].Intensive Care Med,1996,22(Suppl 4):S474-481.
  • 3Bone R C,Balk R A,Cerra F B,et al.Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis[J].Chest,1992,101:1644-1655.
  • 4LeGall J R,Loirat P,Alperovitch A.APACHE Ⅱ:a severity of disease classification system[J].Crit Care Med,1986,14:754-755.
  • 5Bone R C.Sir Isaac Newton,sepsis,SIRS,and CARS[J].Crit Care Med,1996,24:1125-1128.
  • 6Bone R C.Immunologic dissonance:a continuing evolution in our understanding of the systemic inflammatory response syndrome (SIRS) and the multiple organ dysfunction syndrome(MODS)[J].Ann Intern Med,1996,125:680-687.
  • 7Hynninen M,Pettila V,Takkunen O,et al.Predictive value of monocyte histocompatibility leukocyte antigen-DR expression and plasma interleukin4 and-10 levels in critically ill patients with sepsis[J].Shock,2003,20:1-4.
  • 8Lekkou A,Karakantza M,Mouzaki A,et al.Cytokine production and monocyte HLA-DR expression as predictors of outcome for patients with community-acquired severe infections[J].Clin Diagn Lab Immunol,2004,11:161-167.
  • 9Heidecke C D,Hensler T,Weighardt H,et al.Selective defects of T lymphocyte function in patients with lethal intraabdominal infection[J].Am J Surg,1999,178:288-292.
  • 10Weighardt H,Heidecke C D,Emmanuilidis K,et al.Sepsis after major visceral surgery is associated with sustained and interferon-γ resistant defects of monocyte cytokine production[J].Surgery,2000,127:309-315.

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