摘要
Abstract
Objective To observe the clinical efficacy of ulinastatin injection and thymalfasin for injection in the treatment of sepsis patients and their effects on peripheral blood T lymphocyte subsets.Methods Sepsis patients were divided into control group and treatment group according to the cohort method.The control group was treated with ulinastatin injection in addition to initial resuscitation,hemoperfusion,and antimicrobial therapy.The treatment regimen was intravenous infusion,2.0 × 105 U bid for 4 days,followed by intravenous pump infusion,1.0 × 105 U bid for 6 days.The treatment group received thymalfasin for injection on base of the control group's treatment,subcutaneous injection,1.6 mg twice a week,for 2 weeks.The clinical efficacy,Sequential Organ Failure Assessment(SOFA)score,Acute Physiology and Chronic Health Evaluation(APACHE)Ⅱ score,peripheral blood procalcitonin(PCT),lactate(Lac),D-dimer(D-D),and levels of T lymphocyte subsets were compared between the two groups,as well as 28-day mortality rate and safety were evaluated.Results A total of 43 patients were enrolled in the control group and 37 patients in the treatment group.After treatment,the total effective rates in the treatment group and the control group were 94.59％(35 cases/37 cases)and 86.05％(37 cases/43 cases),respectively,with no significant difference statistically(P＞0.05).After treatment,the SOFA scores in the treatment group and the control group were(5.46±1.20)and(6.71±1.33)points;the APACHE Ⅱ scores were(16.17±3.49)and(18.63±3.82)points;the peripheral blood PCT levels were(1.51±0.33)and(1.88±0.42)μg·L-1;the Lac levels were(2.73±0.52)and(5.06±1.19)nmol·L-1;the D-D levels were(0.85±0.27)and(1.02±0.33)mg·L-1;the CD3+levels were(38.98±4.36)％and(34.42±4.14)％;the CD4+levels were(18.66±2.47)％and(13.17±1.96)％;the CD8+levels were(12.35±1.42)％and(13.01±1.39)％;and the CD4+/CD8+ratio were 1.49±0.24 and 1.04±0.22,respectively,all showing statistically significant differences(all P＜0.05).The 28-day mortality rates in the treatment group and the control group were 18.92％(7 cases/37 cases)and 23.26％(10 cases/43 cases),respectively,with no significant difference statistically(P＞0.05).No drug-related adverse reactions were observed in either group.Conclusion The clinical efficacy of thymalfasin for injection in the treatment of sepsis is more ideal than that of ulinastatin alone,as it can better reduce the levels of peripheral PCT,Lac,and D-D,regulate T lymphocyte subsets,demonstrating definite efficacy and safety.关键词
注射用胸腺法新/乌司他丁注射液/脓毒症/降钙素原/乳酸/D-二聚体/T淋巴细胞亚群Key words
thymalfasin for injection/ulinastatin injection/sepsis/procalcitonin/lactic acid/D-dimer/T lymphocyte subsets分类
药学
