摘要
目的 研究乌司他丁(ustatin,UTI)对降低严重外伤后脓毒症患者的脏器功能受损的效果.方法 选取琼海市人民医院(2017年1月—2019年2月)收治的严重外伤后脓毒症患者70例,分为两组.对照组给予常规对症治疗,观察组加用UTI治疗.在治疗前,治疗后3 d、7 d收集外周空腹静脉血液样本,检测血管性血友病因子(vascu?lar hemophilia factor,vWF)、白细胞介素-1(interleukin-1,IL-1)、白细胞介素-10(interleukin-10,IL-10),流式细胞仪检查CD4+和CD8+淋巴细胞的水平.观察多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)的发生率、机械通气时间和ICU治疗时间.结果 观察组ICU治疗时间(7.96±1.79)d、机械通气时间(4.25±1.32)d,均短于对照组[分别为(11.85±2.15)d和(8.12±1.69)d.均P<0.05],MODS发生率(17.14%)低于对照组(40.0%,P<0.05).两组治疗前T淋巴细胞亚群、vWF、IL-1、IL-10组间比较,差异不具有统计学意义(P>0.05).观察组治疗3 d、7 d后CD4+(36.76±6.52)%、(45.87±7.10)%、CD4+/CD8+(1.79±0.55)%、(1.86±0.59)%、IL-10(72.31±6.21)ng/L、(80.41±6.32)ng/L水平高于对照组,CD8+(31.14±2.98)%、(27.54±3.29)%、vWF(158.44±31.52)%、(114.52±28.12)%、IL-1(15.41±3.66)ng/mL、(12.32±2.11)ng/mL水平低于对照组(P<0.05).结论 UTI可降低严重外伤后脓毒症患者MODS发生率,减轻炎症反应,改善细胞免疫功能,缩短ICU治疗时间.
Objective To study the effects of ulinaslatin(UTI)on reducing organ function damage in patients with sepsis caused by severe trauma.Methods Seventy patients with severe post-traumatic sepsis were randomly divided into two equal groups:control group treated with routine cluster treatment targeting at sepsis and observation group treated with UTI at the dosage of 200 thousand units given by intravenous injection 3 tomes a day for 7 d in addition to the routine treatment.Before treatment,and 3 days and 7 days after treatment peripheral fasting venous blood samples were collected to test the von Willebrand factor(vWF),Interleukin-1(IL-1)and IL-10 by ELISA and to examine the levels of CD4+and CD8+lymphocytes by flow cytometer.The duration of ICU treatment,time of mechanical ventilation,and incidence of in multiple organ dysfunction syndrome(MODS)were observed.Results The duration of ICU treatment and time of mechanical ventilation of the observation group were(7.96±1.79)d and(4.25±1.32)d,both shorter than those of the control groups[(11.85±2.15)d and(8.12±1.69)d respectively,both P<0.05].The incidence of MODSof the observation group was 17.14%,significantly lower than that of the control group(40.0%,P<0.05).Before treatment,there were no significant differences between the levels of vWF,IL-1,and IL-10 compared of the two groups(all P>0.05).The levels of CD4+(36.76±6.52)%,(45.87±7.10)%,CD4+/CD8+(1.79±0.55)%,(1.86±0.59)%,1L-10(72.31±6.21)ng/L,(80.41±6.32)ng/L in the observation group were higher than those in the control group,CD8+(31.14±2.98)%,(27.54±3.29)%,vWF(158.44±31.52%,(114.52±28.12)%,IL-1(15)%,CD8(31.14±2.98)%,(27.54±3.29)%,vWF(158.44±31.52%),(114.52±28.12)%,IL-1(15)%.41±3.66)ng/mL,(12.32±2.11)ng/mL levels were lower than those in the control group(P<0.05).Conclusion UTI can reduce the incidence of MODS,reduce inflammatory reaction,improve cellular immune function and shorten the treatment time of ICU in patients with severe trauma.
作者
蒙绪君
王光权
陈公海
颜光寰
严思
MENG Xujun;wang Guangquan;CHEN Gonghai;YAN Guanghuan;YAN Si(Department of Critical Care Medicine,Boao Super Hospital,Qionghai 571437 China)
出处
《中国急救复苏与灾害医学杂志》
2020年第6期705-707,716,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
海南省卫计委行业科研项目(编号:16A200034)。
