血必净注射液辅助治疗重症腹腔感染时对T淋巴细胞数量和Toll样受体的影响

摘要

ObjectiveTo examine the effect of Xuebijing Injection on the number of T lymphocytes and Toll-like receptors as adjuvant therapy of severe abdominal infections.MethodsA total of 78 patients with severe abdominal infection who were hospitalized in the intensive care unit were divided into control group and treatment group. The patients in control group received conventional therapy alone, while the patients in treatment group received Xuebijing Injection (50 mL twice daily for 2 weeks) in addition to conventional therapy. Blood sample was drawn before and after 2-week treatment to determine T lymphocytes. The peripheral blood mononuclear cells were separated to determine the expression of Toll-like receptors (TLR) 2 and TLR4. The Acute Physiology and Chronic Health Evaluation (APACHE) II score and gastrointestinal function score were recorded before and after treatment.ResultsThe levels of CD3+, CD4+ and CD4+/CD8+ of peripheral blood in the Xuebijing-treated patients were signiifcantly higher than those in control group (P<0.01), but the levels of CD8+ was signiifcantly lower than that in control group (P<0.01). The levels of TLR2 and TLR4 mRNA of the peripheral blood mononuclear cells in the treatment group were signiifcantly lower than those in control group (P<0.01). The APACHE II score and gastrointestinal function score in treatment group were signiifcantly lower than those in control group (P<0.01).ConclusionXuebijing Injection as adjuvant therapy of severe abdominal infection can improve the number of T lymphocytes, and reduce the expression of Toll-like receptors.%目的：观察血必净注射液辅助治疗重症腹腔感染时对T淋巴细胞数量和Toll样受体（TLR）的作用。方法选取2013年1月—2014年12月重症腹腔感染患者78例，随机分为对照组和观察组（每组39例），两组患者均接受常规基础治疗，观察组患者在常规治疗基础上静脉滴注血必净注射液，50 mL/次，2次/d，连用2周。治疗前及治疗2周时抽取患者静脉血采用流式细胞术测定T淋巴细胞水平，分离外周血单个核细胞（PBMC）并采用荧光实时PCR测定TLR2和TLR4表达水平，记录两组患者入院时及治疗2周时的急性生理与慢性健康评分（APACHEⅡ评分）和胃肠功能评分。结果治疗2周时，观察组患者外周血CD3+、CD4+和CD4+/CD8+水平均较对照组患者显著升高（P＜0.01），而CD8+水平较对照组患者显著降低（P＜0.01）；观察组患者外周血PBMC TLR2和TLR4 mRNA水平均较对照组患者显著降低（P＜0.01）；观察组患者APACHEⅡ评分和胃肠功能评分均较对照组患者显著降低（P＜0.01）。结论血必净注射液辅助治疗重症腹腔感染时可改善患者的T淋巴细胞数量及降低外周血PBMC上TLR的表达。