血必净注射液对重症脓毒症患者机体炎性反应和细胞免疫功能的影响

目的 评价血必净注射液对重症脓毒症患者机体炎性反应和细胞免疫功能的影响.方法 选择2008年9月至2009年8月ICU收治的62例确诊重症脓毒症患者,按随机数字表法分为治疗组30例和对照组32例,两组均给予脓毒症集束化治疗,治疗组加用血必净注射液100ml静脉滴注,2次/d,连续使用7d,观察两组患者治疗前后血清肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-6、IL-10、C反应蛋白(CRP)以及外周血T淋巴细胞亚群CD4+、CD8+、CD4+CD8+和CD14+单核细胞人类白细胞抗原(HLA)-DR表达的变化.结果 两组患者治疗前血清TNF-α、IL-6、IL-10和CRP水平以及外周血CD4+、CD8+、CD4+/CD8+和CD14+单核细胞HLA-DR表达比较差异无统计学意义(P＞0.05).与对照组比较,治疗组治疗后血清TNF-α、IL-6、IL-10、CRP水平显著降低(64.4±13.5) ng/L比(96.1 ±22.1) ng/L,(153.8 ±23.8) ng/L比(180.1 ±21.7) ng/L,(73.8±13.8) ng/L比(101.1±11.7)ng/L,(53.7±18.8) mg/L比(91.3±32.8) mg/L,P＜ 0.05],而外周血CD4+、CD8+、CD4+/CD8+升高(0.311±0.021比0.424±0.035,0.201±0.017比0.238±0.038,1.78±0.21比1.56±0.18,P＜ 0.05 ),CD14+单核细胞HIA-DR表达上调(38.4±11.5)％比(18.1±12.1)％,P＜0.05].结论 血必净注射液可降低重症脓毒症患者机体炎性反应,纠正细胞免疫功能紊乱,有助于改善患者病情.

Effect of xuebijing injection on inflammatory response and cellular immune function in patients with severe sepsis

Objective To evaluate the effect of xuebijing injection on inflammatory response and cellular immune function in patients with severe sepsis.Methods Sixty-two patients with severe sepsis from September 2008 to August 2009 were divided into treatment group (30 patients) and control group (32patients) by random digits table.All the patients received sepsis-bundle therapy and patients in treatment group added xuebijing injection therapy with 100 ml,twice a day,for 7 days.The levels of serum tumor necrosis factor-alpha(TNF-α ),interleukin(IL)-6,IL-10 and C-reactive protein (CRP),peripheral blood T lymphocyte CD4+、CD8+ 、CD4+/CD8+,the expression of human leucocyte antigen (HLA)-DR on CD14+peripheral blood mononuclear cell (PBMC) were detected before and aftertreatment.Results There was no significant difference in the levels of serum TNF-o,IL-6,IL-10,CRP,peripheral blood Tlymphocyte CD4+、CD8+、CD4+/CD8+ and the expression of HLA-DR on CD14+ PBMC before treatment between two groups(P ＞ 0.05).After treatment,compared with those in control group,the levels of serum TNF- α,IL-6,IL-10 and CRP in treatment group were significantly decreased ( 64.4 ± 13.5) ng/L vs.(96.1 ± 22.1 ) ng/L,( 153.8 ± 23.8 ) ng/L vs.(180.1 ± 21.7) ng/L,(73.8 ± 13.8) ng/L vs.(101.1 ± 11.7) ng/L,(53.7 ± 18.8) mg/L vs.(91.3 ± 32.8)mg/L,P ＜0.05],while peripheral blood T lymphocyte CD4+/CD8+ and the expression of HLA-DR on CD14+PBMC were significantly increased 0.311 ± 0.021 vs.0.424 ± 0.035,0.201 ± 0.017 vs.0.238 ± 0.038,1.78 ±0.21 vs.1.56 ±0.18,(38.4 ± 11.5)％ vs.(18.1 ± 12.1)％,P＜0.05].Conclusion Xuebijing injection can reduce the inflammatory response and ameliorate immune disorder in patients with severe sepsis.