中国病理生理杂志2009，Vol.25Issue(11)：2168-2172,5.
乌司他丁联合胸腺肽α_1改善脓毒症患者免疫功能的作用机制研究
Effect of ulinastatin plus thymosin - α_1 therapy on improving immune function in septic patients
摘要
Abstract
AIM: To investigate the effect of ulinastatin plus thymosin - a, therapy on improving immune function in septic patients. METHODS: 70 patients were divided into two groups. One group was classical treatment group ( CT) with regular therapy and another group was classical treatment plus immunotherapy group ( CIT) with ulinastatin plus thymosin -a, for a week. The immune index before and after treatment on day 0,1,3 and 7 was observed, including the clinical and survival data. RESULTS: The most common pathogen of sepsis was bacteria, and infection by fungi was in rare. The common locations of bacteria observed were sputum and abdominal drainage. The level of TNF - α was significant lower in CIT group than that in CT group (P <0.05). IL - 10 level was significantly higher in CIT group than that in CT group (P < 0.05 ). IgG level was significant lower in CIT group than that in CT group (P < 0.05 ). No significant difference in the levels of IgA, IgM, C_3 and C_4 between two groups was observed (P > 0.05 ). CD4~+ T lymphocytes were significant higher in CIT group than those in CT group (P < 0.05 ). From day 7 to day 28, the lymphocytes and level of HLA -DR in CD14~+ monocytes were significant higher in CIT group than those in CT group (P < 0.05). The time of mechanical ventilation and vasopressors used in CIT group was shorter than those in CT group ( P < 0.05 ). But the length of stay and the cost in ICU showed no significant increase between these two groups (P >0.05). During hospitalization, 20 patients died in the CT group and 13 patients died in CIT group ( P < 0.05 ). The long - term survival time in CIT group was longer than that in CT group ( P < 0.05 ). CONCLUSION: Immunotherapy in septic patients can decrease TNF - α level and increase IL - 10 level. Immunotherapy in septic patients can increase IgC level slightly, CD4~+ T lymphocyte, and HLA - DR in CD14~+ monocytes, which improve the immune paralysis in septic patients. Immunotherapy can shorten the time of mechanical ventilation and vasopressors used, but it doesn't increase the length of stay and the cost.关键词
脓毒症/多器官功能衰竭/免疫治疗Key words
Sepsis/ Multiple organ failure/ Immunotherapy分类
医药卫生引用本文复制引用
黄顺伟,管向东,陈娟,欧阳彬,杨春华,陈敏英..乌司他丁联合胸腺肽α_1改善脓毒症患者免疫功能的作用机制研究[J].中国病理生理杂志,2009,25(11):2168-2172,5.基金项目
中山大学5010计划资助项目(No:2007015) （No:2007015）
