静脉免疫球蛋白治疗感染中毒症的临床观察

Clinical Observation on Intravenous Immunoglobulin in Treatment of Sepsis

目的:探讨静脉注射免疫球蛋白(IVIG)对感染中毒症患者预后及血清炎性介质的影响。方法:将48例感染中毒症患者随机分成治疗组和对照组,治疗组在综合治疗的基础上加用IVIG400mg/(kg.d),每天1次,连用3d。观察两组患者APACHEⅡ评分的变化、呼吸机使用天数、抗生素使用天数、ICU住院天数、多器官功能障碍综合征(MODS)的发生率及ICU住院病死率。同时分别于治疗后1、2、3、5、7d采用酶联免疫吸附法(ELISA)检测血清TNF-α及IL-6水平。结果:治疗组呼吸机与抗生素使用天数、ICU住院天数、MODS的发生率、ICU住院病死率均低于对照组,其差异有统计学意义(P<0.05)。治疗组患者血清TNF-α、IL-6水平和A-PACHEⅡ评分在治疗后2、3、5、7d明显低于对照组(P<0.05)。结论:IVIG可降低感染中毒症患者的促炎因子水平并改善患者的预后。

Objective：To investigate the effect of intravenous immunoglobulin（MG）on prognosis and serum inflammatory cytokine levels in patients with sepsis. Methods：Forty-eight patients with sepsis were randomly divided into IVIG group and control group. 400 mg/kg MG per day was administered intravenously for 3 days together with conventional treatment in MG group. APACHE II scores, days of using mechanical ventilation and antibiotics, duration of ICU hospitalization, ICU mortality and the morbidity of multiple organ dysfunction syndrome were observed. Serum levels of TNF-α and IL-6 were detected by ELISA on 1,2,3,5 and 7 days after treatment. Results： Days of using mechanical ventilation and antibiotics, duration of ICU stay, ICU mortality and the morbidity of MODS in patients with MG group were significantly less than those in control group （P〈0. 05）. Serum levels of TNF-α,IL-6 and APACHE II scores in patients with MG group were significantly lower than those in control group（P〈0, 05）. Conclusion： IVIG can reduce the serum inflammatory cytokine levels and improve the prognosis of patients with sepsis.