[1]刘涵,陈翔宇,黄崧,等.乌司他丁对严重多发伤患者早期炎症及T淋巴细胞免疫反应的影响及其临床价值[J].第三军医大学学报,2019,41(17):1666-1671.
 LIU Han,CHEN Xiangyu,HUANG Song,et al.Effect of ulinastatin on early inflammatory and T lymphocyte immune responses in patients with severe multiple trauma and its clinical value[J].J Third Mil Med Univ,2019,41(17):1666-1671.
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乌司他丁对严重多发伤患者早期炎症及T淋巴细胞免疫反应的影响及其临床价值(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
41卷
期数:
2019年第17期
页码:
1666-1671
栏目:
临床医学
出版日期:
2019-09-15

文章信息/Info

Title:
Effect of ulinastatin on early inflammatory and T lymphocyte immune responses in patients with severe multiple trauma and its clinical value
作者:
刘涵陈翔宇黄崧张元松邓文君刘明华
陆军军医大学(第三军医大学)第一附属医院急救部
Author(s):
LIU Han CHEN Xiangyu HUANG Song ZHANG Yuansong DENG Wenjun LIU Minghua

Center of Emergency, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China

关键词:
乌司他丁创伤和损伤肿瘤坏死因子&alpha白细胞介素6皮质醇T淋巴细胞亚群
Keywords:
ulinastatin trauma and injuries tumor necrosis factor-alpha interleukin-6 cortisol T-lymphocyte subsets
分类号:
R642.05; R969.4; R977.6
文献标志码:
A
摘要:

目的探讨乌司他丁在严重多发伤患者早期炎症及T淋巴细胞免疫中的作用,并分析其临床价值。方法选取我科2016年1月至2019年1月收治的严重多发伤患者40例,采用随机数字表法分为对照组和乌司他丁治疗组(n=20)。对照组患者给予常规治疗;乌司他丁治疗组患者在其基础上,入院当天即开始连续7 d静脉滴注乌司他丁(100 kU、3次/d),分别比较两组患者治疗前及治疗后第1、3、7天外周血T淋巴细胞亚群变化,以及肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)、皮质醇及各临床相关指标的差异。结果与对照组患者比较,在治疗后第1、3、7天,乌司他丁治疗组患者CD3+、CD4+、CD4+/CD8+明显升高(P<0.05),TNF-α、IL-6及皮质醇水平显著降低(P<0.05),两组患者谷丙转氨酶(ALT)、尿素氮(BUN)、肌酐(Scr)值差异不明显;两组患者平均住院时间、入住ICU时间、并发症发生率间差异均有统计学意义(P<0.05),但病死率差异无统计学意义。结论乌司他丁应用于严重多发伤后早期,能促进T淋巴细胞亚群的恢复,减少炎症细胞因子的释放,抑制炎症反应,减少ICU入住和平均住院时间,降低并发症发生率,但不能改善病死率。

Abstract:

ObjectiveTo investigate the roles of ulinastatin in early inflammatory and T lymphocyte immune responses in patients with severe multiple trauma and analyze its clinical value. MethodsForty patients with severe multiple-trauma admitted in our center from January 2016 to January 2019 were enrolled in this study, and randomly divided into ulinastatin group (n=20) and control group (n=20). The patients of the control group were given conventional treatment, and those of the ulinastatin group were given an intravenous infusion of ulinastatin, 100 kU, 3 times per day, from the day of admission for 7 consecutive days besides conventional treatment. The counts of T lymphocyte subsets (CD3+ and CD4+), ratio of CD4+/CD8+ , levels of inflammatory factors (TNF-α and IL-6 ) and cortisol, and other clinical relevant indexes were measured and compared before treatment, on days 1, 3 and 7 after treatment, respectively. ResultsThe counts of CD3+ and CD4+ lymphocytes and the ratio of CD4+/CD8+ were significantly higher in the ulinastatin group than the control group on days 1, 3 and 7 after treatment (P<0.05), while the serum levels of TNF-α, IL-6 and cortisol were obviously lower (P<0.05). There were no notable differences in the levels of alpha-alanine aminotransferase (ALT), urea nitrogen (BUN) and creatinine (Scr) between the 2 groups. But significant differences were seen in the average length of hospital stay, length of ICU stay and incidence of complications between them (P<0.05), though no difference in mortality. ConclusionUlinastatin can promote the recovery of T lymphocyte subsets, decrease the release of inflammatory cytokines and reduce the inflammatory response in early after severe multiple injuries, and thus can reduce the lengths of ICU stay and hospital stay and incidence of complications, but it has no effect on mortality.
 

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更新日期/Last Update: 2019-09-09