中国中西医结合急救杂志
中國中西醫結閤急救雜誌
중국중서의결합급구잡지
INTEGRATED TRADITIONAL CHINESE AND WESTERN MEDICINE IN PRACTICE OF CRITICAL CARE MEDICINE
2013年
6期
337-340
,共4页
陆洋%沈浩亮%王林华%崔晓莉%赵宏胜
陸洋%瀋浩亮%王林華%崔曉莉%趙宏勝
륙양%침호량%왕림화%최효리%조굉성
血必净注射液%脓毒症%髓样细胞触发受体-1%炎症因子%中西医结合疗法
血必淨註射液%膿毒癥%髓樣細胞觸髮受體-1%炎癥因子%中西醫結閤療法
혈필정주사액%농독증%수양세포촉발수체-1%염증인자%중서의결합요법
Xuebijing injection%Sepsis%Triggering receptor-1 expression on myeloid cell%Inflammatory mediator%Integrated traditional Chinese and western medicine therapy
目的：观察血必净注射液对严重感染患者髓样细胞触发受体-1（TREM-1）的表达及可溶性TREM-1（sTREM-1）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）水平的影响。方法将入住南通大学附属医院重症医学科的20例严重感染患者分为血必净组和对照组，每组10例；按2004年严重感染和感染性休克治疗指南的原则进行综合治疗，其中血必净组在常规综合治疗基础上加用血必净注射液50 mL，每日3次，疗程5～7 d。检测两组患者治疗前及治疗后3 d和5 d全血TREM-1 mRNA表达及血浆sTREM-1、TNF-α、IL-6水平的变化。结果两组治疗前TREM-1 mRNA表达及sTREM-1、TNF-α、IL-6水平比较差异均无统计学意义（均P＞0.05）。治疗后两组TREM-1的表达及血浆TNF-α、IL-6水平均较治疗前下降，且血必净组较对照组下降更为显著，差异有统计学意义〔TREM-1 mRNA 3 d：1.065±0.277比1.217±0.301， t＝-3.267，P＝0.047；5 d：0.912±0.239比1.071±0.254，t＝-5.072，P＝0.032；sTREM-1（ng/L）：146.93±13.76比176.22±19.46，t＝-5.442，P＝0.033；TNF-α（ng/L）：77.51±11.28比107.72±13.17，t＝-4.355，P＝0.032；IL-6（ng/L）：288.35±14.59比323.89±24.51，t＝-3.941，P＝0.028〕。结论早期给予血必净注射液可以下调TREM-1的表达及其下游炎症因子的水平，有较好的控制炎症反应的作用，对加强改善严重感染患者的全身炎症反应综合征有积极意义。
目的：觀察血必淨註射液對嚴重感染患者髓樣細胞觸髮受體-1（TREM-1）的錶達及可溶性TREM-1（sTREM-1）、腫瘤壞死因子-α（TNF-α）、白細胞介素-6（IL-6）水平的影響。方法將入住南通大學附屬醫院重癥醫學科的20例嚴重感染患者分為血必淨組和對照組，每組10例；按2004年嚴重感染和感染性休剋治療指南的原則進行綜閤治療，其中血必淨組在常規綜閤治療基礎上加用血必淨註射液50 mL，每日3次，療程5～7 d。檢測兩組患者治療前及治療後3 d和5 d全血TREM-1 mRNA錶達及血漿sTREM-1、TNF-α、IL-6水平的變化。結果兩組治療前TREM-1 mRNA錶達及sTREM-1、TNF-α、IL-6水平比較差異均無統計學意義（均P＞0.05）。治療後兩組TREM-1的錶達及血漿TNF-α、IL-6水平均較治療前下降，且血必淨組較對照組下降更為顯著，差異有統計學意義〔TREM-1 mRNA 3 d：1.065±0.277比1.217±0.301， t＝-3.267，P＝0.047；5 d：0.912±0.239比1.071±0.254，t＝-5.072，P＝0.032；sTREM-1（ng/L）：146.93±13.76比176.22±19.46，t＝-5.442，P＝0.033；TNF-α（ng/L）：77.51±11.28比107.72±13.17，t＝-4.355，P＝0.032；IL-6（ng/L）：288.35±14.59比323.89±24.51，t＝-3.941，P＝0.028〕。結論早期給予血必淨註射液可以下調TREM-1的錶達及其下遊炎癥因子的水平，有較好的控製炎癥反應的作用，對加彊改善嚴重感染患者的全身炎癥反應綜閤徵有積極意義。
목적：관찰혈필정주사액대엄중감염환자수양세포촉발수체-1（TREM-1）적표체급가용성TREM-1（sTREM-1）、종류배사인자-α（TNF-α）、백세포개소-6（IL-6）수평적영향。방법장입주남통대학부속의원중증의학과적20례엄중감염환자분위혈필정조화대조조，매조10례；안2004년엄중감염화감염성휴극치료지남적원칙진행종합치료，기중혈필정조재상규종합치료기출상가용혈필정주사액50 mL，매일3차，료정5～7 d。검측량조환자치료전급치료후3 d화5 d전혈TREM-1 mRNA표체급혈장sTREM-1、TNF-α、IL-6수평적변화。결과량조치료전TREM-1 mRNA표체급sTREM-1、TNF-α、IL-6수평비교차이균무통계학의의（균P＞0.05）。치료후량조TREM-1적표체급혈장TNF-α、IL-6수평균교치료전하강，차혈필정조교대조조하강경위현저，차이유통계학의의〔TREM-1 mRNA 3 d：1.065±0.277비1.217±0.301， t＝-3.267，P＝0.047；5 d：0.912±0.239비1.071±0.254，t＝-5.072，P＝0.032；sTREM-1（ng/L）：146.93±13.76비176.22±19.46，t＝-5.442，P＝0.033；TNF-α（ng/L）：77.51±11.28비107.72±13.17，t＝-4.355，P＝0.032；IL-6（ng/L）：288.35±14.59비323.89±24.51，t＝-3.941，P＝0.028〕。결론조기급여혈필정주사액가이하조TREM-1적표체급기하유염증인자적수평，유교호적공제염증반응적작용，대가강개선엄중감염환자적전신염증반응종합정유적겁의의。
Objective To investigate the effects of Xuebijing injection on expression of myeloid cell triggering receptor-1(TREM-1)and the plasma levels of soluble TREM-1(sTREM-1),tumor necrosis factor-α(TNF-α), interleukin-6(IL-6)in patients with severe sepsis. Methods Twenty patients with severe sepsis admitted into Critical Care Medicine Department,Affiliated Hospital of Nantong University were given comprehensive treatments according to the guidelines for management of severe sepsis and septic shock(2004),and they were divided into Xuebijing group and control group(each 20 cases). The Xuebijing injection group was given Xuebijing injection 50 mL,3 times daily for 5-7 days followed by regular treatments. The changes in blood TREM-1 mRNA expression and plasma concentrations of sTREM-1,TNF-α,and IL-6 were detected before and after treatments on the 3rd and 5th day,and the above indexes were compared between the two groups. Results Before treatments,there were no significant differences in TREM-1 mRNA expression and levels of sTREM-1,TNF-α,IL-6 between two groups (all P>0.05). The TREM-1 expression and plasma concentrations of sTREM-1,TNF-α,and IL-6 of two groups were declined after treatments compared to their baselines,the degree of decline being more prominent in Xuebijing group〔TREM-1 mRNA 3 days:1.065±0.277 vs. 1.217±0.301,t=-3.267,P=0.047;5 days:0.912±0.239 vs. 1.071±0.254,t=-5.072,P=0.032;sTREM-1(ng/L):146.93±13.76 vs. 176.22±19.46,t=-5.442,P=0.033;TNF-α(ng/L):77.51±11.28 vs. 107.72±13.17,t=-4.355,P=0.032;IL-6(ng/L):288.35±14.59 vs. 323.89± 24.51, t=-3.941,P=0.028〕. Conclusion Early implication of Xuebijing injection is of great significance in patients with severe sepsis,it may reduce the expression level of TREM-1 and serum levels of downstream inflammatory mediators,that is beneficial to the control of inflammatory responses and improvement of systemic inflammatory response syndrome in such patients.
