摘要
目的:研究去甲肾上腺素联合磷酸肌酸钠对脓毒症患者早期循环衰竭及免疫功能的影响。方法:将2015年12月至2017年12月入住我院的80例脓毒症患者纳入本研究,并分为观察组和治疗组。观察组进行基础治疗,治疗组患者经去甲肾上腺素联合磷酸肌酸钠联合治疗。分别在治疗前、治疗后1、2周时观察患者,测定其APACHEⅡ评分,统计其在EICU入住的天数。检测联合治疗后患者外周血免疫细胞CD4 +/CD8 +分布比例和WBC计数,生化分析血中CRP、HBP、PCT、IL-6、cTnI和TNF-α的含量,同时分析体内微循的变化情况。结果:脓毒症患者治疗前CRP、HBP、PCT、IL-6、cTnI和TNF-α含量高于治疗后,并且治疗后CD4 +细胞亚群提高、WBC计数降低、体内微循环好转( P <0.05)。此外,联合治疗组治疗后患者的微循环状态、CD4 +细胞亚群提高、WBC计数和生化指标的改善情况好于同期观察组患者( P <0.05)。结论:去甲肾上腺素联合磷酸肌酸钠能增强机体免疫功能,降低血液中炎症因子,减少心肌损伤程度,改善脓毒症患者微循环,对脓毒症患者早期循环衰竭的病情有一定帮助。
Objective: To study the effects of norepinephrine combined with creatine phosphate on early circulatory failure and immune function in patients with sepsis. Methods: 80 patients with sepsis collected from December 2015 to December 2017 in our hospital were included and divided into observation group and treatment group.The patients in observation group were treated with basic therapy,while the patients in treatment group was treated with norepinephrine and creatine phosphate.One or two weeks before or after therapy,the APACHE Ⅱ scores of patients were measured and the number of days in EICU was counted.The distribution of CD4 +/CD8 +and WBC count were detected.The contents of CRP,HBP,PCT,IL-6,cTnI and TNF-α in blood were analyzed.The change of microcirculation was also analyzed. Results: The values of CRP,HBP,PCT,IL-6,cTnI and TNF-α before therapy were much higher than those after therapy,and the levels of CD4 + cell subsets,WBC cell count and microcirculation were also improved after therapy,the level of myocardial injury was reduced ( P <0.05).In addition,the indexes mentioned above in treatment groups were better than those of observation group in the same period ( P <0.05). Conclusion: The noradrenaline combined with creatine phosphate could effectively enhance the immune function of sepsis patients,improve their microcirculation,reduce their myocardial injury,and decrease their inflammatory factors,which would be helpful to the early circulatory failure of patients with sepsis.
作者
康大伟
于健
夏嘉鼎
李秀华
朴宗方
赵艳军
KANG Da-Wei;YU Jian;XIA Jia-Ding;LI Xiu-Hua;PIAO Zong-Fang;ZHAO Yan-Jun(Emergency Department, Affiliated Hospital of Chengde Medical College,Chengde 067000,China)
出处
《中国免疫学杂志》
CAS
CSCD
北大核心
2019年第11期1368-1372,共5页
Chinese Journal of Immunology
基金
2018年度河北省医学科学研究重点课题计划(20181165)
