高渗氯化钠羟乙基淀粉40注射液对感染性休克患者血浆中细胞因子水平的影响

目的:观察高渗氯化钠羟乙基淀粉40注射液(hypertonic sodium chloride hydroxyethyl starch 40 injection,HSH40)对感染性休克患者血浆中细胞因子水平的影响。方法:将60例肠梗阻伴感染性休克手术患者随机分为两组,每组各30例。治疗组(Ⅰ组)为HSH40组;对照组(Ⅱ组)为复方乳酸钠林格氏液(LRS)组。全麻诱导成功后,30min内按10mL/kg输入HSH40或LRS。分别于患者入室时(T0)、输液后30min(T1)、手术结束时(T2),采用酶联免疫吸附法(ELISA)测定血浆肿瘤坏死因子α(TNF-α)、白细胞介素-1β(IL-1β)、IL-6和IL-10水平。结果:与T0比较,Ⅰ组T1、T2时TNF-α、IL-1β、IL-6水平明显降低(P<0.05),而IL-10水平明显升高(P<0.05);在T1、T2两个时点,Ⅰ组与Ⅱ组比较,TNF-α、IL-1β、IL-6水平明显降低(P<0.05),而IL-10水平明显升高(P<0.05);与T0比较,Ⅱ组T1、T2时TNF-α、IL-1β、IL-6和IL-10水平变化并不明显(P>0.05)。结论:HSH40对感染性休克患者的炎症反应有一定调控作用。

Effects of hypertonic sodium chloride hydroxyethyl starch 40 injection on cytokines of patients with septic shock

AIM: To investigate the effect of intravenous infusion with hypertonic sodium chloride hydroxyethyl starch 40 injection(HSH40) on cytokines of patients with septic shock.METHODS: 60 operated patients with intestinal obstruction and septic shock were randomly divided into two groups(30 in each group).Therapy group(Group Ⅰ)was administrated with HSH40 at a dose of 10 mL/kg for 30 min after anesthesia induction.Control group(Group Ⅱ) was received the same amount of lactated Ringer’s solution(LRS).Blood samples were taken at the following time point,immediately enter the operation room(T0),at 30 min after infusion(T1) and at the end of surgery(T2),the levels of TNF-α,IL-1β,IL-6 and IL-10 in plasma were measured by ELISA.RESULTS:Compared with T0,the levels of plasma TNF-α,IL-1β and IL-6 were decreased at T1 and T2 in groupⅠ(P<0.05),while the level of plasma IL-10 was increased(P<0.05).Compared with group Ⅱat T1 and T2,the levels of plasma TNF-α,IL-1β and IL-6 were decreased in groupⅠ(P<0.05),while the level of plasma IL-10 was increased(P<0.05).Compared with T0,the levels of plasma TNF-α,IL-1β,IL-6 and IL-10 at each time point had no significant difference in GroupⅡ(P>0.05).CONCLUSION: HSH40 may modulate the inflammation response during septic shock.