乌司他丁与胸腺肽联合应用于脓毒症对血清细胞因子及免疫细胞的影响

Effect of Ulinastatin Combined with Thymosin on Serum Cytokines and Immune Cells in Sepsis

目的探讨乌司他丁与胸腺肽联合应用于脓毒症对血清细胞因子及免疫细胞的影响。方法方便选取2016年1月—2019年1月在该院重症监护室接受治疗的88例脓毒血症患者,随机分为实验组(n=44)和对照组(n=44)。对照组患者予常规治疗,实验组患者在对照组的基础上予乌司他丁联合胸腺肽治疗。比较两组患者治疗前后的急性生理与慢性健康评分(APACHE-Ⅱ)、多器官功能障碍综合症评分(MODS)、炎性因子[白细胞介素6(IL-6)、白细胞介素10(IL-10)、肿瘤坏死因子α(TNF-α)]和免疫细胞(CD4^+、CD4^+/CD8^+)水平。结果治疗后,两组APACHE-Ⅱ评分和MODS评分均下降,且实验组下降水平高于对照组[APACHE-Ⅱ:(10.23±2.47)分vs(15.06±2.82)分,MODS:(3.09±0.63)分vs(5.12±0.84)分](tAPACHE-Ⅱ=8.546,tMODS=12.824,P<0.05);两组白细胞介素6、白细胞介素10和肿瘤坏死因子α水平下降,CD4^+和CD4^+/CD8^+水平上升,且实验组改善水平优于对照组,以上均差异有统计学意义(tIL-6=8.431,tIL-10=8.770,tTNF-α=12.843,tCD4^+=5.127,tCD4^+/CD8^+=7.337,P<0.05)。结论乌司他丁与胸腺肽联合有利于提高脓毒症患者的临床疗效,改善血清细胞因子和免疫细胞水平。

Objective To observe the effects of ulinastatin combined with thymosin on serum cytokines and immune cells in patients with sepsis.Methods Eighty-eight patients with sepsis who were treated in our intensive care unit from January 2016 to January 2019 were convenient randomly divided into experimental group(n=44)and control group(n=44).Patients in the control group were treated with conventional therapy,and patients in the experimental group were treated with ulinastatin and thymosin on the basis of the control group.Acute and chronic health scores(APACHE-II),multiple organ dysfunction syndrome(MODS),inflammatory factors[interleukin-6(IL-6),interleukin-10(IL-10)tumor necrosis factor alpha(TNF-alpha)and immune cell(CD4^+,CD4^+/CD8^+)levels before and after treatment were compared between the two groups.Results After treatment,both APACHE-II scores and MODS scores decreased,and the experimental group decreased the level higher than the control group[APACHE-II:(10.23±2.47)points vs(15.06±2.82)points,MODS:(3.09±0.63)points vs(5.12±0.84)points](tAPACHE-II=8.546,tMODS=12.824,P<0.05);the levels of interleukin-6,interleukin-10 and tumor necrosis factorαdecreased,CD4^+and CD4^+/CD8^+level was increased,and the improvement level of the experimental group was better than that of the control group.The above differences were statistically significant(tIL-6=8.431,tIL-10=8.770,tTNF-α=12.843,tCD4^+=5.127,tCD4^+/CD8^+=7.337,P<0.05).Conclusion The combination of ulinastatin and thymosin is beneficial to improve the clinical efficacy of patients with sepsis and improve serum cytokines and immune cells.