摘要
目的探讨胸腺肽d，对脓毒症（sepsis）患者免疫功能的影响及评估预后。方法42例脓毒症患者随机分为治疗组与对照组，两组患者均按照2008年脓毒症治疗指南进行治疗，治疗组在对照组基础上加用胸腺肽d。1．6mg皮下注射，每天1次，连续7d。分别在治疗前（D_0）及治疗后3d（D，）、7d（D_0）留取标本查T细胞亚群，免疫球蛋白IgG、IgA、IgM，炎性物质PCT、IL-6、IL-10，并记录APACHEⅡ评分，28d死亡率。结果在治疗后7d治疗组与对照组比较CIM^＋T细胞、CIM^＋T／CD8^＋T比值、IgG、IL-10均升高，差异有统计学意义（P〈0．05）。在治疗后7d治疗组与对照组比较APACHEII评分、PCT、IL-6明显下降，差异有统计学意义（P〈0．05）。与对照组比较，治疗组28d死亡率稍下降，差异无统计学意义（P〉0．05）。结论胸腺肽理，治疗脓毒症患者可增强细胞免疫，对其体液免疫、炎性反应存在改善作用，能改善病情，对预后的影响尚待进一步研究。
To evaluate the curative effect of thymosin α and its effects on immune function in the patients with sepsis. Methods 42 patients with sepsis in the intensive care unit （ICU） were enrolled and were randomly divided into treatment group and control group, all the patients had been given a standard treatment in accordance with the guidelines for the treatment of sepsis in 2008. 1.6 mg of thymosin αwas injected subcutaneously once a day for 7 days in treatment group. T cell subsets, immunoglobulin IgG, IgA, IgM and PCT, IL6, IL10 were measured before treatment （ D_0）, 3 days （ D_3 ） and 7 days （ D）7 ） after the beginning of treatment respectively. Simuhaneously, APACHE I1 score and 28 day mortality were recorded. Results After 7 day treatment CD4 ^＋ T cell count, CD4 ^＋ T/CD8 ^＋T ratio,IgG and IL10 were higher in the treatment group than in the control group, the difference was statistically significant （P 〈 0.05 ）. Compare with control group, APACHE Ⅱ score, PCT and IL 6 was significantly decreased （ P 〈 0.05 ） , and 28 day mortality was mildly declined in treatment group （ P 〉 0.05 ）. Conclusion Thymosin α in sepsis therapy regimen may enhance cellular immunity,improve humoral immunity and promote disease recovery. However, further investigation was required to clarify its effects on the prognosis of sepsis.
出处
《中国急救医学》
CAS
CSCD
北大核心
2012年第3期255-258,共4页
Chinese Journal of Critical Care Medicine
