高渗氯化钠羟乙基淀粉40注射液对感染性休克患者血浆中细胞因子水平的影响

Effects of hypertonic sodium chloride hydroxyethyl starch 40 injection on cytokines of patients with septic shock

目的:观察高渗氯化钠羟乙基淀粉40注射液(hypertonic sodium chloride hydroxyethyl starch 40 injection,HSH40)对感染性休克患者血浆中细胞因子水平的影响。方法:将60例肠梗阻伴感染性休克手术患者随机分为两组,每组各30例。治疗组(Ⅰ组)为HSH40组;对照组(Ⅱ组)为复方乳酸钠林格氏液(LRS)组。全麻诱导成功后,30min内按10mL/kg输入HSH40或LRS。分别于患者入室时(T0)、输液后30min(T1)、手术结束时(T2),采用酶联免疫吸附法(ELISA)测定血浆肿瘤坏死因子α(TNF-α)、白细胞介素-1β(IL-1β)、IL-6和IL-10水平。结果:与T0比较,Ⅰ组T1、T2时TNF-α、IL-1β、IL-6水平明显降低(P<0.05),而IL-10水平明显升高(P<0.05);在T1、T2两个时点,Ⅰ组与Ⅱ组比较,TNF-α、IL-1β、IL-6水平明显降低(P<0.05),而IL-10水平明显升高(P<0.05);与T0比较,Ⅱ组T1、T2时TNF-α、IL-1β、IL-6和IL-10水平变化并不明显(P>0.05)。结论:HSH40对感染性休克患者的炎症反应有一定调控作用。

To investigate the effect of intravenous infusion with hypertonic sodium chloride hydroxyethyl starch 40 injection （HSH40） on cytokines of patients with septic shock. METHODS： 60 operated patients with in- testinal obstruction and septic shock were ran- domly divided into two groups （30 in each group）. Therapy group （Group Ⅰ ）was adminis trated with HSH40 at a dose of 10 mL/kg for 30 rain after anesthesia induction. Control group （Group Ⅱ ） was received the same amount of lactated Ringer＇s solution（LRS）. Blood samples were taken at the following time point, immedi- ately enter the operation room（T0）, at 30 rain after infusion （T1） and at the end of surgery （T2）, the levels of TNF-α, IL-β, IL-6 and IL- l0 in plasma were measured by ELISA. RE-SULTS：Compared with To, the levels of plasma TNF-α, IL-1β and IL-6 were decreased at T1 and T2 in group Ⅰ （P〈0.05）, while the level of plasma IL-10 was increased （P 〈 0.05）. Com- pared with group Ⅱ at T1 and Te, the levels of plasma TNF-α, IL-1β and IL-6 were decreased in group （P〈0.05）, while the level of plasma IL-10 was increased （P〈0.05）. Compared with To, the levels of plasma TNF-α, IL-1β, IL-6 and IL-10 at each time point had no significant differ ence in Group Ⅱ （P〈0.05）. CONCLUSION. HSH40 may modulate the inflammation response durining seontie shock