乌司他丁对慢性阻塞性肺疾病患者外周血TLR4、TNF-α及HMGB1水平的影响

Impact of ulinastatin on peripheral TLR4,TNF-α and HMGB1 in patients with COPD

目的探讨乌司他丁对慢性阻塞性肺病(慢阻肺)患者临床疗效及外周血单核细胞样受体(TLR4)、肿瘤坏死因子-α(TNF-α)及高迁移率族蛋白B1(HMGB1)水平的影响。方法将120例慢阻肺患者随机分为观察组及对照组各60例,对照组应用常规抗感染、祛痰、平喘及吸氧治疗,观察组在对照组基础上应用乌司他丁治疗,对比分析两组患者治疗效果及治疗前后肺功能、外周血TLR4、TNF-α及HMGB1水平的变化。结果观察组总有效率为96.67%,对照组总有效率为83.33%,差异有统计学意义(P<0.05)。观察组治疗后FEV1(58.26±5.22)%、FVC(66.02±5.86)%及FEV1/FVC(65.36±6.22)%水平均高于对照组(49.25±6.32)%、(58.98±6.21)%、(58.22±5.96)%,差异有统计学意义(P<0.05)。观察组治疗后TLR4、TNF-α及HMGB1水平均低于对照组(P<0.05)。结论乌司他丁能有效降低患者外周血TLR4、TNF-α及HMGB1水平,减轻炎症反应对机体的影响,有利于改善肺功能,提高患者治疗效果。

Objective To investigate the impact of of ulinastatin on peripheral TLR4, TNF-α and HMGB1 in patients with COPD. Methods 120 patients with COPD were randomly divided into the observation group （ n = 60） and the control group （n = 60）. The control group was given conventional anti-infection, expectorant, asthma prevention and oxygen inhalation, and the observation group was additionally treated with UTI. Their pulmonary function, TLR4, TNF-α and HMGB1 of the two groups were compared. Results The total effective rate was 96. 67% and 83.33% respectively in the observation group and the control group （P 〈 0. 05 ）. The levels of FEVl （58.26 ± 5.22） %, FVC （66. 02 ± 5.86 ） % and FEV1/FVC （ 65.36 ± 6. 22 ） % of the observation group were higher than those in the control groups [ （49.25 ± 6. 32）%, （58.98 ± 6. 21 ）%, （58.22 ± 5.96）% ] after treatment （P 〈 0. 05）. The levels of TLR4, TNF-α and HMGB1 of the observation group were lower than in the control group （P 〈 0. 05）. Conclusion UTI can effectively reduce the peripheral blood TLR4, TNF-α and HMGB1 levels, reduce the impact of inflammation on the body, and improve lung function and outcomes.