乌司他丁对重症肺炎免疫及炎症因子影响观察

摘要

目的：探讨乌司他丁对重症肺炎免疫反应及炎症因子的影响。方法选取在我院治疗的重症肺炎患者146例,采用随机数字表法将患者分为观察组(n=73)和对照组(n=73),对照组给予抗生素、补液、营养支持等常规治疗,观察组在对照组常规治疗基础上给予乌司他丁治疗,观察两组治疗前后炎症因子、血气指标变化以及治疗疗效。结果观察组治疗总有效率为91．78%,明显高于对照组的75．34%,P<0．05；观察组和对照组治疗后 Th1细胞较治疗前升高, Th2细胞较治疗前降低( P <0．05)；观察组治疗后 Th1为(15．02±3．27)%,明显高于对照组,而Th2为(8．33±5．01)%,明显低于对照组(P<0．05)；观察组和对照组治疗后TNF-α、IL-6和IL-8水平较治疗前降低, IL-10较治疗前升高, P<0．05；观察组治疗后TNF-α、IL-6和IL-8分别为分别为(150．28±62．02)ng/L、(71．02±16．35)ng/L和(41．04±13．73)ng/L,明显低于对照组,而IL-10为(142．51±48．33)ng/L明显高于对照组(P<0．05)；观察组和对照组治疗后PH、PaO2较治疗前升高,而PaCO2较治疗前有所降低(P<0．05)。结论乌司他丁治疗重症肺炎,可能通过提高细胞免疫功能,抑制炎症反应,改善患者氧合情况,从而缓解病情。%Objective To investigate the effect of ulinastatin on immune and inflammatory factors of severe pneumonia. Methods From January 2013 to February 2015 in our hospital, 146 patients with severe pneumonia were randomly divided into the observation group ( n=73 ) and the control group ( n=73 ) . The control group was given antibiotics, fluid replacement, nutritional support and other conventional treatment, and the observation group was additionally given ulinastatin. The inflammatory factors, blood gas indexes changes and curative effect were ob-served. Results The total effective rate of the observation group was 91. 78%, significantly higher than that of the control group (75. 34%,) (P<0. 05). The levels of Th1 and Th2 were lower after the treatment than before (P<0. 05). After the treatment, the level of Th1 was (15. 02 ± 3. 27)% in the observation group, significantly higher than that in the control group, while the level of Th2 was (8. 33 ± 5. 01)% in the observation group, significantly lower than in the control group (P<0. 05). The levels of TNF-, IL-6 and IL-8 decreased significantly and the level of IL-10 increased after the treatment (P<0. 05). The levels of TNF-, IL-6 and IL-8 were (150. 28 ± 62. 02) ng/L, (71. 02 ± 16. 35) ng/L and (41. 04 ± 13. 73) ng/L in the observation group, which were significantly lower than those in the control group, while the level of IL-10 was (142. 51 ± 48. 33) ng/L, which was significantly higher than that in the control group (P<0. 05). Conclusion Ulinastatin can improve the cellular immune function, inhibit in-flammation and oxygenation in the treatment of patients with severe pneumonia.