脾多肽对ICU呼吸机相关性肺炎患者细胞免疫功能和治疗效果的影响

Impact of splenic polypeptide on cellular immune function and therapeutic effect in patients with VAP in ICU

目的探讨脾多肽治疗对ICU呼吸机相关性肺炎(VAP)患者细胞免疫功能及临床效果的作用。方法回顾性分析2018年2月至2019年6月该院ICU收治的并发VAP患者的临床资料。患者分为常规治疗组和常规治疗加用脾多肽的脾多肽组。比较两组患者的一般资料和免疫细胞、免疫蛋白和血清中白细胞介素(IL)在治疗10 d中的变化情况。结果治疗前两组患者一般资料差异无统计学意义(P>0.05)。治疗后,脾多肽治疗组患者CD3^+、CD4^+、CD8^+、CD4^+/CD8^+、NK细胞百分率、IgA、IgM、IgG及IL-35均高于治疗前,IL-18显著低于治疗前(P<0.05)。两组的CD3^+和CD4^+在10 d中都呈上升趋势(P<0.05)。脾多肽组治疗后的CD3^+和CD4^+值显著高于常规治疗组(P<0.05)。脾多肽组较常规治疗组患者的体温下降时间更短、有效例数更多、ICU住院时间更短、机械通气时间更短、抗菌药物使用时间更短(P<0.05)。结论应用脾多肽辅助治疗可以调节患者免疫功能,具有提高重症呼吸机相关性肺炎患者的细胞免疫作用和治疗效果。

Objective To investigate the effect of splenic polypeptide(SPP)therapy on the cellular immune function and therapeutic effect in the patients with ventilator-associated pneumonia(VAP)in ICU.Methods The clinical data of the patients with VAP admitted to ICU of this hospital from February 2018 to February 2019 were retrospectively analyzed.The patients were divided into the routine treatment group and routine treatment plus SPP group(SPP group).The general data and the changes of immune cells,immune proteins and serum interleukins during 10 d treatment were compared between the two groups.Results There was no statistical difference in general data before treatment between the two groups.After treatment,the percentages of CD3^+,CD4^+,CD8^+,CD4^+/CD8^+,NK cells,and the levels of IgA,IgM,IgG and IL-35 in the SPP group were higher than those before treatment,and the IL-18 level was significantly lower than that before treatment(P<0.05).The levels of CD3^+and CD4^+during 10 d in the two groups showed the increasing trend(P<0.05).The values of CD3^+and CD4^+after treatment in the SPP groups were significantly higher than those in the routine treatment group(P<0.05).The SPP group had shorter body temperature decrease time compared with the routine treatment group,had more effective cases,shorter hospitalization duration,shorter ventilation time and shorter time of antibacterial drugs(P<005).Conclusion Using theSPP adjuvant therapy can regulate the immune function of the patients,and improve the cellular immunity and therapeutic effect in the patients with severe VAP.