脾多肽对急性脑出血致全身炎症反应综合征的疗效观察

Efficacy of lienal polypeptide in treatment of acute intracerebral hemorrhage patients complicated with systemic inflammatory reaction syndrome

目的探讨脾多肽对急性脑出血致全身炎症反应综合征(SIRS)患者的疗效及其可能机制。方法将86例急性脑出血伴SIRS患者按随机数字表法分为常规治疗组和脾多肽联合治疗组,每组43例。两组患者均给予常规治疗,脾多肽联合治疗组在常规治疗的基础上加用脾多肽注射液10ml/d静脉滴注10d。观察并比较两组患者治疗前及治疗第3、7、10天的体温、呼吸、心率、WBC、超敏C反应蛋白(hs-CRP)、TNF-α、IL-1水平的变化,以及多器官功能障碍综合征(MODS)的发生率。结果脾多肽联合治疗组体温、呼吸、心率、WBC较常规治疗组改善情况更为明显(P<0.05或0.01)。两组患者hs-CRP、TNF-α、IL-1水平在治疗第7天均较治疗前显著下降(P<0.05或0.01),脾多肽联合治疗组下降更为显著(P<0.05或0.01)。脾多肽联合治疗组MODS发生率较常规治疗组显著降低(P<0.05)。结论脾多肽注射液对急性脑出血致SIRS患者的症状具有明显的改善作用,可抑制炎性细胞因子的释放,能明显降低MODS的发生率。

Objective To evaluate the efficacy of lienal polypeptide in treatment of acute intracerebral hemorrhage patients complicated with systemic inflammatory reaction syndrome（SIRS）.Methods Eighty six acute intracerebral hemorrhage patients complicated with SIRS were randomized assigned in study and control groups with 43 cases in each group.The routine comprehensive therapy was given to both groups.The additional intravenous infusion of lienal polypeptide10ml/d was given to study group for 10 d.The symptoms of SIRS were observed;serum hs-CRP,TNF-α and IL-1 levels were measured before and 3,7,lOd after treatment,the incidence of multiorgan disorder syndrome（MODS） was compared between two groups.Results The improvement rate of SIRS in study group was more marked than that in control group（P〈0.05）.Serum hs-CRP,IL-1 and TNF-α levels were significantly decreased compared to those of pretreatment after 7d of treatment in both groups（P〈0.05）,however,the changes were more marked in study group（P〈0.05）.The incidence of MODS in study group was significantly lower than that in control group（P〈0.05）.Conclusion Lienal polypeptide injection can significantly improve the symptoms and reduce the incidence of MODS,which is associated with the inhibition of inflammatory factors in acute intracerebral hemorrhage patients complicated with SIRS.