他汀类药物对全身炎症反应综合征血清中IL-6及 IL-10的影响

摘要

目的：观察他汀类药物对全身炎症反应综合征患者血清中 IL-6及 IL-10水平的影响。方法168例全身炎症反应综合征（SIRS）患者按是否应用他汀类药物分为他汀治疗组和非他汀治疗组，另取20名健康志愿者作为正常对照组。非他汀治疗组（102例）给予常规治疗，在此基础上，他汀治疗组（66例）加用他汀类药物。比较两组治疗前后血清中 IL-6及 IL-10水平变化，并统计多器官功能障碍综合征（MODS）发生率及病死率。结果感染后致 SIRS 患者入院时三种炎性因子水平明显高于正常对照组（P ＜0．05），两治疗组间差异无显著性（P ＞0．05）。两治疗组治疗后4 d 及7 d 血清 IL-6水平较治疗前均明显下降（P ＜0．05），但他汀治疗组较非他汀治疗组下降更为明显（P ＜0．05）；两治疗组治疗后4 d 血清 IL-10水平较治疗前上升（P ＜0．05），治疗后7 d 血清 IL-10水平较治疗前显著上升（P ＜0.05），他汀治疗组较非他汀治疗组上升更为明显（P ＜0．05）；他汀治疗组发生 MODS 为16例（24．2％），非他汀治疗组发生 MODS 为25例（24．5％），两组差异无统计学意义（χ2＝0．002，P ＝0．969＞0．05）；他汀治疗组病死为17例（25．8％），非他汀治疗组病死为43例（42．2％），两组比较有统计学差异（χ2＝4．694，P ＝0．030＜0．05）。结论全身炎症反应综合征患者应用他汀类药物能促进 IL-6水平下降和 IL-10水平升高，进一步改善全身炎症反应，但仍需大规模随机对照试验进行验证。%Objective To observe the effect of atorvastatin on the levels of serum IL-6 and IL-10 in patients with systemic inflammatory response syndrome.Methods 168 cases of systemic inflammatory response syndrome were di-vided into statin treatment group and no statin treatment group,and 20 healthy volunteers were selected as a normal control group.no statin treatment group was given conventional treatment,based on the no statin treatment group,sta-tin treatment group were gave statins.The difference of,IL-6 and IL-10 levels in serum were compared between the two groups before and after treatment in the two groups,and organ dysfunction syndrome (MODS)incidence and case fatal-ity rate were statistic.Results Infection induced SIRS in patients of three kinds of inflammatory factor levels were sig-nificantly higher than that in the normal group (P <0.05),the difference between the two treatment groups was not significant (P >0.05).The two groups after the treatment of 4 d and 7 d plasma IL-6 level decreased(P <0.05),but the test group than in the control group decreased more significantly (P <0.05);the two group 4 d after treatment than before treatment plasma IL-10 level rise (P <0.05),7 d after treatment the plasma IL-10 level than before treat-ment significantly increased(P < 0.05),the test group than in the control group increased more significantly (P <0.05);statin treatment group appeared MODS for 16 cases (24.2%),no statin treatment group appeared MODS for 25 cases (24.5%),significant difference was not found in two groups (χ2 = 0.002,P = 0.969 > 0.05),statin treatment group die for 17 cases (25.8%),no statin treatment group die for 43 cases (42.2%),significant difference was found in two groups (χ2 =4.694,P =0.030<0.05).Conclusion The systemic inflammatory response syndrome combined with atorvastatin can increase IL-6 decreased and IL-10 level,improve the systemic inflammatory response.