高乌甲素对 ICU 脓毒症患者免疫功能的影响

Effect of lappaconitine on the immune function of sepsis patients in ICU

目的：研究高乌甲素对ICU脓毒症患者细胞因子表达水平和T细胞亚群的影响，从而探讨高乌甲素在脓毒症治疗中的免疫调节作用。方法将2013－10～2014－08入住我院重症医学科的脓毒症患者80例随机分为常规治疗组（36例），给予常规集束化治疗；高乌甲素组（44例），在常规集束化治疗基础上加用肌肉注射氢溴酸高乌甲素注射液一次4 mg，每天1～2次，连续3 d。测定血浆中肿瘤坏死因子（TNF－α）、白细胞介素－4（IL－4）、白细胞介素－6（IL－6）、白细胞介素－10（ IL－10）和CD4＋、CD8＋T细胞亚群。结果与常规治疗组比较，高乌甲素组TNF－α、IL－6水平明显下降， IL－4、IL－10水平明显升高， T 细胞亚群CD4＋、CD8＋、CD4＋／CD8＋均明显上升（ P＜0．05）。结论高乌甲素对脓毒症患者可以降低炎症反应，改善脓毒症患者的免疫功能。

Objective To investigate the effect of Lappaconitine on the immune function of patients with sepsis.Methods Eighty patients with sepsis admitted from Oct 2013 to Aug 2014 in the First Hospital of Lanzhou University, were divided into two groups.One was control group with 36 patients who were administrated to conventional therapy, and the other was therapy -group with 44 patients who were administrated to conventional therapy associated with Lappaconitine injection of 4 mg, twice a day, for 3 consecutive days.The patients peripheral bloods were collected, in which TNF-α, IL-4, IL-6 and IL-10 concentration was measured, whereas CD4 ＋and CD8 ＋T cell sub-group was determined under flow cytometry.Results TNF-αand IL-6 concentration decreased apparently in Lappaconitine therapeutic group vs control group （P〈0.05）, but IL-4 and IL-10 concentration was increased （ P 〈0.01）.And CD4 ＋, CD8 ＋, CD4 ＋/CD8 ＋level was higher in therapeutic group as compared to that of control group.Conclusion Lappaconitine can decrease inflammatory reaction of the sepsis patients through which adjust immune system.