中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2013年
7期
720-723
,共4页
庄育田%白士先%孙继玲%马云%董娜
莊育田%白士先%孫繼玲%馬雲%董娜
장육전%백사선%손계령%마운%동나
血必净%肺挫伤%细胞因子
血必淨%肺挫傷%細胞因子
혈필정%폐좌상%세포인자
Xuebijing%Pulmonary contusion%Cytokine
目的 探讨血必净对肺挫伤患者炎性细胞因子肿瘤坏死因子α(TNF-α)、血管性假血友病因子(vWF)、白细胞介素6(IL-6)的调节作用及治疗效果的影响.方法 选取2010年1月至2012年1月我院收治的肺挫伤患者51例,随机分为治疗组及对照组.采用酶联免疫吸附试验测定肺挫伤患者TNF-α、vWF、IL-6浓度,观察治疗组及对照组炎性细胞因子的变化及治疗效果.结果 治疗组与对照组住院时间分别为(19.83±2.35)、(21.52±2.73)d,治疗组住院时间明显缩短(t=2.38,P＜0.05)；急性呼吸窘迫综合征发生率分别为14.81％ (4/27),41.67％(10/24),治疗组发生率明显降低(x2=4.60,P＜0.05)；治疗组与对照组炎症指标分别为TNF-α第1天(181.35±14.25)、(179.17±16.28) ng/L,第3天(169.21±16.42)、(179.18±17.31) ng/L,第5天(131.78±13.02)、(140.84±14.27) ng/L,第7天(99.45±16.02)、(110.56±17.09) ng/L;vWF第1天(178.73±22.09)、(177.73±23.02) ng/L,第3天(208.46±14.13)、(220.53±23.02) ng/L,第5天(252.32±15.22)、(266.40±25.79) ng/L,第7天(201.49±9.21)、(217.27±22.68) ng/L;IL-6第1天(172.14±12.41)、(169.53±13.55) ng/L,第3天(147.24±16.33)、(158.41±21.04) ng/L,第5天(126.36±11.37)、(137.21±21.23)ng/L,第7天(114.03±10.26)、(122.16±13.59) ng/L,其差异均具有统计学意义(F组内=206.58、P＜0.01,F组间=19.053、P＜ 0.01;F组内=218.57、P＜0.01,F组间=17.259、P＜0.01;F组内=198.35、P＜0.01,F组间=17.235、P＜0.01).且第3、5、7天3项指标浓度治疗组均低于对照组(P均 ＜0.01).结论 血必净能抑制肺挫伤患者机体炎性细胞因子的产生,减轻炎症反应,降低ARDS发生率,缩短病程,有助于改善严重肺挫伤患者的预后.
目的 探討血必淨對肺挫傷患者炎性細胞因子腫瘤壞死因子α(TNF-α)、血管性假血友病因子(vWF)、白細胞介素6(IL-6)的調節作用及治療效果的影響.方法 選取2010年1月至2012年1月我院收治的肺挫傷患者51例,隨機分為治療組及對照組.採用酶聯免疫吸附試驗測定肺挫傷患者TNF-α、vWF、IL-6濃度,觀察治療組及對照組炎性細胞因子的變化及治療效果.結果 治療組與對照組住院時間分彆為(19.83±2.35)、(21.52±2.73)d,治療組住院時間明顯縮短(t=2.38,P＜0.05)；急性呼吸窘迫綜閤徵髮生率分彆為14.81％ (4/27),41.67％(10/24),治療組髮生率明顯降低(x2=4.60,P＜0.05)；治療組與對照組炎癥指標分彆為TNF-α第1天(181.35±14.25)、(179.17±16.28) ng/L,第3天(169.21±16.42)、(179.18±17.31) ng/L,第5天(131.78±13.02)、(140.84±14.27) ng/L,第7天(99.45±16.02)、(110.56±17.09) ng/L;vWF第1天(178.73±22.09)、(177.73±23.02) ng/L,第3天(208.46±14.13)、(220.53±23.02) ng/L,第5天(252.32±15.22)、(266.40±25.79) ng/L,第7天(201.49±9.21)、(217.27±22.68) ng/L;IL-6第1天(172.14±12.41)、(169.53±13.55) ng/L,第3天(147.24±16.33)、(158.41±21.04) ng/L,第5天(126.36±11.37)、(137.21±21.23)ng/L,第7天(114.03±10.26)、(122.16±13.59) ng/L,其差異均具有統計學意義(F組內=206.58、P＜0.01,F組間=19.053、P＜ 0.01;F組內=218.57、P＜0.01,F組間=17.259、P＜0.01;F組內=198.35、P＜0.01,F組間=17.235、P＜0.01).且第3、5、7天3項指標濃度治療組均低于對照組(P均 ＜0.01).結論 血必淨能抑製肺挫傷患者機體炎性細胞因子的產生,減輕炎癥反應,降低ARDS髮生率,縮短病程,有助于改善嚴重肺挫傷患者的預後.
목적 탐토혈필정대폐좌상환자염성세포인자종류배사인자α(TNF-α)、혈관성가혈우병인자(vWF)、백세포개소6(IL-6)적조절작용급치료효과적영향.방법 선취2010년1월지2012년1월아원수치적폐좌상환자51례,수궤분위치료조급대조조.채용매련면역흡부시험측정폐좌상환자TNF-α、vWF、IL-6농도,관찰치료조급대조조염성세포인자적변화급치료효과.결과 치료조여대조조주원시간분별위(19.83±2.35)、(21.52±2.73)d,치료조주원시간명현축단(t=2.38,P＜0.05)；급성호흡군박종합정발생솔분별위14.81％ (4/27),41.67％(10/24),치료조발생솔명현강저(x2=4.60,P＜0.05)；치료조여대조조염증지표분별위TNF-α제1천(181.35±14.25)、(179.17±16.28) ng/L,제3천(169.21±16.42)、(179.18±17.31) ng/L,제5천(131.78±13.02)、(140.84±14.27) ng/L,제7천(99.45±16.02)、(110.56±17.09) ng/L;vWF제1천(178.73±22.09)、(177.73±23.02) ng/L,제3천(208.46±14.13)、(220.53±23.02) ng/L,제5천(252.32±15.22)、(266.40±25.79) ng/L,제7천(201.49±9.21)、(217.27±22.68) ng/L;IL-6제1천(172.14±12.41)、(169.53±13.55) ng/L,제3천(147.24±16.33)、(158.41±21.04) ng/L,제5천(126.36±11.37)、(137.21±21.23)ng/L,제7천(114.03±10.26)、(122.16±13.59) ng/L,기차이균구유통계학의의(F조내=206.58、P＜0.01,F조간=19.053、P＜ 0.01;F조내=218.57、P＜0.01,F조간=17.259、P＜0.01;F조내=198.35、P＜0.01,F조간=17.235、P＜0.01).차제3、5、7천3항지표농도치료조균저우대조조(P균 ＜0.01).결론 혈필정능억제폐좌상환자궤체염성세포인자적산생,감경염증반응,강저ARDS발생솔,축단병정,유조우개선엄중폐좌상환자적예후.
Objective To investigate the effects of Xuebijing on the regulations of tumor necrosis factor-α(TNF-α) 、von Wilebrand factor(vWF)、interleukin-6 (IL-6) and the treatment effectiveness in pulmonary contusion patients.Methods Fifty-one pulmonary contusion patients admitted into the hospital from January 2010 to January 2012 were enrolled in the study and were randomly divided into two groups (treatment group and control group).The levels of the TNF-α、vWF 、IL-6 in the pulmonary contusion patients were measured by enzyme linked immunosorbent assay to investigate the change of the inflammatory cytokines and the treatment effectiveness in treatment group and control group.Results The hospitalization time of treatment group and control group was (19.83 ± 2.35) d,(21.52 ± 2.73) d respectively,the hospitalization time of the treatment group was significantly shorter than the control group,the difference was statistically significant (t =2.38,P ＜0.05) ;The incidence of ARDS was 14.81％ and 41.67％ respectively,the incidence of ARDS of the treatment group was significantly lower,the difference was statistically significant (x2 =4.6,P ＜ 0.05) ;The inflammatory mediators index of the two groups showed as follws:the first day of the TNF-α(181.35 ± 14.25) ng/L,(179.17 ± 16.28) ng/L,the third day of the TNF-α(169.21 ± 16.42) ng/L,(179.18 ± 17.31) ng/L,the fifth day of the TNF-α(131.78 ± 13.02) ng/L,(140.84 ± 14.27) ng/L,the seventh day of the TNF-α (99.45 ± 16.02)ng/L,(110.56 ± 17.09) ng/L;The first day of the vWF (178.73 ± 22.09) ng/L,(177.73 ± 23.02) ng/L,the third day of the vWF (208.46 ± 14.13) ng/L,(220.53 ± 23.02) ng/L,the fifth day of the vWF (252.32 ±15.22) ng/L,(266.40 ±25.79) ng/L,the seventh day of the vWF(201.49 ±9.21) ng/L,(217.27 ±22.68)ng/L;The first day of the IL-6 (172.14 ± 12.41) ng/L,(169.53 ± 13.55) ng/L,the third day of the IL-6 (147.24 ± 16.33) ng/L,(158.41 ±21.04) ng/L,the fifth day of the IL-6(126.36 ± 11.37) ng/L,(137.21 ± 21.23) ng/L,the seventh day of the IL-6 (114.03 ± 10.26) ng/L,(122.16 ± 13.59) ng/L,the differences within the group and between the two groups were significant(within the group:F =206.58,218.57,198.35 respectively,P ＜ 0.01 ;between the groups:F =19.053,17.259,17.235 respectively,P ＜ 0.01).And in the third,fifth and seventh day,3 indicators of treatment groups were lower than the control group (P ＜ 0.01).Conclusion Xuebijing can inhibit inflammatory transmitters,relieve inflammatory reactions,decrease the rate of ARDS incidence,shorten the hospitalization time and help to improve the prognosis of the patients with acute pulmonary contusion.
