乌司他丁对重症手足口病患儿血清炎症因子的影响

Impact of ulinastatin on serum inflammatory factors when treated children with severe hand-foot-mouth disease

目的研究乌司他丁治疗重症手足口病患儿时对其血清炎症因子的影响。方法选择2012年2月~2015年3月入住我院ICU的重症手足口病患儿共32例,将他们随机分为两组,即对照组（16例）和乌司他丁组（16例）。对照组按照手足口病诊治指南进行常规救治,乌司他丁组则在对照组的基础上加用乌司他丁,比较治疗前后两组患者血清炎症因子水平（肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）和白细胞介素-10（IL-10）的变化。结果入ICU时两组患儿TNF-α、IL-1β、IL-6和IL-10水平均高于正常值,但组间比较差异无统计学意义（P〉0.05）;将两组患儿组内进行（即入ICU时与3 d后）比较,可见两组患儿经3 d治疗后TNF-α、IL-1β和IL-6水平明显下降,血清IL-10水平明显升高（P〈0.05）;经治疗3 d后的乌司他丁组与对照组比较,乌司他丁组血清TNF-α[（3.72±1.05）ng/L比（6.68±2.36）ng/L,P〈0.05]、IL-1β[（2.34±0.74）ng/L比（9.64±2.87）ng/L,P〈0.01]和IL-6[（3.93±1.38）ng/L比（6.62±1.48）ng/L,P〈0.05]水平明显降低,血清IL-10[（37.89±10.17）ng/L比（21.41±9.73）ng/L,P〈0.05]水平明显升高。结论用乌司他丁治疗重症手足口病患儿可明显改善患儿血清炎症因子指标,其具有明显的抗炎效果,值得临床推广应用。

Objective To explore the impact of ulinastatin on serum inflammatory factors when treated children with severe hand-foot-mouth disease. Methods 32 children with severe hand-foot-mouth disease,hospitalization in ICU of our hospital,from February 2012 to March 2015 were selected. Patients were randomly divided into control group（n=16）and ulinastatin group（n=16）.Patients in control group were given routine therapy according to diagnosis and treatment guideline of hand-foot-mouth disease.Patients in ulinastatin group were given further treatment of ulinastatin.The changes of level of serum inflammatory factors liked tumornecrosis factor-α（TNF-α）,interleukin-1β（IL-1β）and interleukin-10（IL-10）in two groups were compared before and after treatment. Results When entered the ICU,the levels of TNF-α,IL-1β,IL-6 and IL-10 in two groups children were higher than normal value, but there was no significant difference between two groups（P〉0.05）.Compared the children patients within the group（entered the ICU and 3 days after entered ICU）showed that the levels of TNF-α,IL-1β and IL-6 decreased significantly after treated for 3 days, and the level IL-10 significantly increased（P〈0.05）.After treatment for 3 days,compared with control group, the level of serum TNF-α[（3.72±1.05）ng/L vs（6.68±2.36）ng/L,P〈0.05],IL-1β[（2.34±0.74）ng/L vs（9.64±2.87）ng/L,P〈0.01]and IL-6[（3.93±1.38）ng/L vs（6.62±1.48）ng/L,P〈0.05] were significantly decreased, the level of serum IL-10 was significantly increased[（37.89±10.17）ng/L vs（21.41±9.73）ng/L,P〈0.05]. Conclusion Using ulinastatin treats children patients with severe hand-foot-mouth disease can improve the index of serum inflammatory factors.It has evident anti-inflammatory effect and worth to popularize in clinical.