乌司他汀对急性肺损伤患者外周血单核细胞mCD14、HLA-DR表达的影响

Effect of ulinastatin on the expresion of mCD14 and HLA-DR of monocytes in peripheral blood in patients with acute lung injury

目的探讨乌司他汀(UTI)对急性肺损伤(ALI)患者外周血单核细胞mCD14、HLA-DR表达的影响。方法选择ALI患者60例,随机分为UTI组和常规组,每组30例,同时选择健康体检者30例为正常对照组。所有患者于治疗前、治疗后5 d监测患者ApacheⅡ评分、氧合指数(PO2/FiO2)及外周血单核细胞mCD14、HLA-DR的表达,同时记录机械通气时间、住ICU时间。结果患者外周血单核细胞mCD14、HLA-DR表达率较对照组明显降低(P<0.05);UTI组治疗后PO2/FiO2较常规组明显改善,机械通气时间及住ICU时间较常规组明显缩短(P<0.05),外周血单核细胞mCD14、HLA-DR表达率较常规组明显升高(P<0.05)。结论 UTI可以改善脓毒症ALI患者机体的免疫功能,缩短机械通气时间及住ICU时间,改善预后。

Objective To investigate the effect of ulinastatin on the expression of mCD14 and HLA-DR of monocytes in peripheral blood in patients with acute lung injury （ALl）. Methods Sixty patients with acute lung injury were randomly divided into ulinastatin treatment group （ n = 30） and routine treatment group （ n = 30）. 30 healthy subjects were selected as normal control group. The expression rates of mCD14 and HLA-DR of monocytes in peripheral blood were detected by flow cytometry, and Apach II scoring, oxygenation index （ PO2/FiO2 ）, duration of mechanical ventilation and the time staying in ICU were observed. Results The expression rates of mCDI4 and HLA-DR of monocytes were decreased significantly in patients with acute lung injury, as compared with those in normal control group （ P 〈0.05 ）. After treatment the PO2/FiO2 was obviously improved in ulinastatin treatment group, as compared with that in routine treatment group, and the duration of mechanical ventilation and time staying in ICU were obviously shortened, as compared with those in routine treatment group. The expression rates of mCD14 and HLA-DR of monocytes in ulinastatin treatment group were significantly increased, as compared with those in routine treatment group （ P 〈 0.05 ）. Condusion Ulinastatin can improve immune functions in patients with acute lung injury caused by sepsis, and can shorten the duration of mechanical ventilation and time staying in ICU and can improve patients＇ prognosis.