CAJ | 학술논문

目的：观察参附注射液对严重脓毒症患者的临床疗效及对T淋巴细胞亚群（CD3+、CD4+、CD8+）、NK细胞、单核细胞人白细胞DR抗原（HLA- DR）表达率的影响。方法将68例严重脓毒症患者随机分为西医常规治疗基础上加用参附注射液治疗组（参附组，36例）和单纯西医常规治疗组（对照组，32例）。观察治疗前及治疗后第3、7天患者临床疗效及T淋巴细胞亚群、NK细胞、单核细胞HLA- DR表达率的变化。结果两组患者治疗前APACHE II、Marshal 评分、IL-6和IL-10水平的差异均无统计学意义（均P＞0.05）；与健康对照组比较，严重脓毒症患者血清IL-6、IL-10和CRP水平明显升高，CD3+、CD4+、CD8+T淋巴细胞和单核细胞HLA- DR表达降低（均P＜0.05）。与对照组同期比较，治疗后第7天参附组APACHEII、Marshal 评分及IL-6和CRP水平均下降，而CD3+、CD4+、CD8+T淋巴细胞、NK细胞及单核细胞HLA- DR表达均升高，差异均有统计学意义（均P＜0.05）。结论严重脓毒症患者全身炎症反应和免疫抑制同时存在；参附注射液具有维持促炎/抗炎平衡，双向调节严重脓毒症免疫紊乱作用，从而改善临床疗效。
목적：관찰삼부주사액대엄중농독증환자적림상료효급대T림파세포아군（CD3+、CD4+、CD8+）、NK세포、단핵세포인백세포DR항원（HLA- DR）표체솔적영향。방법장68례엄중농독증환자수궤분위서의상규치료기출상가용삼부주사액치료조（삼부조，36례）화단순서의상규치료조（대조조，32례）。관찰치료전급치료후제3、7천환자림상료효급T림파세포아군、NK세포、단핵세포HLA- DR표체솔적변화。결과량조환자치료전APACHE II、Marshal 평분、IL-6화IL-10수평적차이균무통계학의의（균P＞0.05）；여건강대조조비교，엄중농독증환자혈청IL-6、IL-10화CRP수평명현승고，CD3+、CD4+、CD8+T림파세포화단핵세포HLA- DR표체강저（균P＜0.05）。여대조조동기비교，치료후제7천삼부조APACHEII、Marshal 평분급IL-6화CRP수평균하강，이CD3+、CD4+、CD8+T림파세포、NK세포급단핵세포HLA- DR표체균승고，차이균유통계학의의（균P＜0.05）。결론엄중농독증환자전신염증반응화면역억제동시존재；삼부주사액구유유지촉염/항염평형，쌍향조절엄중농독증면역문란작용，종이개선림상료효。
Objective To assess the efficacy of Shengfu injection (SFI) in treatment of severe sepsis and its effect on im-mune function of patients. Methods Sixty- eight patients with severe sepsis were randomly divided into two groups, 36 patients were treated with Shengfu (SFI group) and conventional therapy and 32 patients received conventional therapy only (control group). The acute physiology and chronic health evaluation II (APACHE II) score and Marshal score were evaluated. The serum levels of interleukins (IL- 6, IL- 10), C- reactive protein, NK cell, CD3+, CD4+, CD8+ T celland monocyte human leukocyte anti-gen- DR (HLA- DR) before and 3, 7 d after treatment were measured. Results There were no significant differences in APACHE II and Marshal scores, serum IL- 6 and IL- 10 levels between two groups before treatment (P>0.05). Before treatment serum IL- 6, IL- 10 and CRP in both groups were significantly higher, and the CD3+, CD4+, CD8+ T cells, NK cells and HLA- DR level were all significantly lower than those of healthy controls (al P<0.05). Compared with the control group, the APACHE II and Mar-shall scores and serum IL- 6, CRP levels in the SFI group were significantly decreased at d7 after treatment, while the CD3 +, CD4+, CD8 +T cells were significantly increased (P<0.05). Conclusion Shengfu injection can improve the therapeutic efficacy of severe sepsis, which may be associated with its effect on regulation of immune function in patients.