摘要
目的观察对脓毒症患者早期应用胸腺肽,对患者淋巴细胞凋亡以及临床疗效的影响。方法选取符合要求的2016年5月-2017年6月在我院重症医学科(ICU)住院的62例脓毒症患者,随机分为胸腺肽组(n=32)和常规组(n=30)。胸腺肽组在常规组治疗的基础上给予胸腺肽1.6mg,皮下注射/qd,连续给药7d为1个疗程。检测2组患者入院时及治疗第3、7d淋巴细胞亚群水平及淋巴细胞凋亡率,同时计算治疗前后2组患者肝肾功能、APACHEII评分以及ICU住院时间、28d生存情况。结果⑴2组患者治疗后各时点淋巴细胞亚群CD4^+水平均较治疗前升高,CD8^+水平均较治疗前降低。治疗3d后比较,胸腺肽组淋巴细胞(CD4^+、CD8^+)水平与常规组无明显差别,差异无统计学意义(P>0.05)。治疗7d后胸腺肽组淋巴细胞CD4^+水平显著高于常规组,差异有统计学意义(P<0.01),CD8^+水平显著低于常规组,差异有统计学意义(P<0.05);⑵2组患者治疗后各时点淋巴细胞凋亡率均较治疗前下降,治疗7d后下降明显。治疗3d后2组患者比较,胸腺肽组淋巴细胞凋亡率与常规组无明显差别,差异无统计学意义(P>0.05)。治疗7d后胸腺肽组淋巴细胞的凋亡率显著低于常规组,差异有统计学意义(P<0.01);⑶2组患者治疗7d后肝肾功能均较治疗前均有改善,治疗后2组患者相比较,差异无统计学意义(P>0.05);2组患者治疗后APACHEII评分比较,胸腺肽组低于常规组,差异有统计学意义(P<0.05);胸腺肽组ICU住院时间低于常规组,差异有统计学意义(P<0.05);⑷2组患者28d死亡率比较,差异无统计学意义(P>0.05)。结论胸腺肽可抑制脓毒症患者淋巴细胞凋亡,改善免疫抑制状态,提高临床疗效。
Objective The effects of the early application of Thymosin on the apoptosis of T lymphocytes and the clinical efficacy of patients with sepsis were discussed. Methods The 62 patients with sepsis who were hospitalized in the intensive care unit （ICU） in our hospital from May 2016 to June 2017 were selected randomly divided into treatment group （n=32） and control group （n=30）. The treatment group was given a total of 1.6mg Thymosin, subcutaneous injection/qd, on the basis of treatment in the control group. Continuous administration of 7 days for a course of treatment. The level of lymphocyte subgroup and lymphocyte apoptosis rate were detected in two groups of patients in the hospital. APACHEII scores were evaluated before and after treatment. Results 1.After treatment, the CD4^＋ levels of lymphocyte subsets in both groups were higher than those before treatment, and the levels of CD8^＋ were lower than before treatment. After 3 days of treatment, the levels of lymphocyte （CD4^＋, CD8^＋） in thymosin group had no significant difference between the two groups, the difference was not statistically significant （P〉0.05）. The level of CD4^＋ in thymosin group was significantly higher than that in the control groupafter 7 days of treatment （P〈0.01）, The level of CD8^＋ was significantly lower than that of the control group, the difference was statistically significant （P〈0.05）. 2.The apoptosis rate of lymphocytes in the two groups after treatment was lower than that before treatment, and decreased obviously after 7 days of treatment.After three days of treatment, the apoptosis rate of lymphocytes in thymosin group was no significant difference between the two groups, the difference was not statistically significant （P〉0.05）. The apoptosis rate of thymosin group after treatment was significantly lower than that of the control group. 3.After treatment for 7 days, the liver and kidney function of the two groups of patients improved compared with those before treatment, b
作者
杨蕙文
喻秋平
叶兴文
刘松
赵鑫
YANG Hui-wen;YU Qiuping;YE Xingwen(The Affiliated Hospital of JiuJiang College,JiuJiang 33200,China)
出处
《江西医药》
CAS
2018年第7期670-673,共4页
Jiangxi Medical Journal
基金
江西省卫生和计生委科技项目课题
编号20185479
