黄芪多糖联合布洛芬对创伤感染患者巨噬细胞分泌功能、T淋巴细胞亚群水平的影响及其影响因素分析

Effect of Astragalus Polysaccharide Combined with Ibuprofen on Macrophage Function and T Lymphocyte Subsets in Patients with Trauma Infection and Analysis of Its Influencing Factors

目的:探讨黄芪多糖联合布洛芬对创伤感染患者巨噬细胞分泌功能、T淋巴细胞亚群水平的影响及影响因素。方法:2014年3月-2018年3月我院收治创伤感染患者85例,其中重度感染39例,将所有患者按感染轻重进行平衡随机分为对照组43例和研究组42例,对照组应用布洛芬治疗,研究组应用黄芪多糖联合布洛芬治疗。比较两组患者巨噬细胞分泌功能、T淋巴细胞亚群水平,分析患者发生重度感染的影响因素及巨噬细胞分泌功能、T淋巴细胞亚群水平与创伤感染的关系。结果:治疗后研究组患者血清中肿瘤坏死因子(TNF)、白介素细胞-6(IL-6)和白介素细胞-1(IL-1)的水平低于对照组(P<0.05)。治疗后研究组外周血中CD3^(+)、CD4^(+)、CD8^(+)和CD4^(+)/CD8^(+)水平高于对照组(P<0.05)。巨噬细胞分泌功能较高、T淋巴细胞亚群水平较低的患者发生重度感染的概率较高(P<0.05);巨噬细胞分泌功能与创伤感染呈正向关联关系(P<0.05,OR>1);T淋巴细胞亚群水平与创伤感染呈负向关联关系(P<0.05,OR<1);治疗方法以研究组方法为优(P<0.05,OR>1)。结论:黄芪多糖联合布洛芬治疗创伤感染患者效果更显著,巨噬细胞分泌功能、T淋巴细胞亚群水平均是创伤感染的影响因素。

Objective: To investigate the effect of astragalus polysaccharide combined with ibuprofen on macrophage function and T lymphocyte subsets in patients with trauma infection and analysis of its influencing factors. Methods: From March 2014 to March 2018,85 patients with traumatic infection were admitted to our hospital, 39 cases of severe infection, all patients were randomly divided into control group(43 cases) and study group(42 cases) according to the degree of infection. The control group was treated with ibuprofen,and the study group with astragalus polysaccharide and ibuprofen. The macrophage secretory function and T lymphocyte subsets were compared between the two groups. The influencing factors of severe infection and the relationship between macrophage secretory function, T lymphocyte subsets and trauma infection were analyzed. Results: After treatment, the levels of tumor necrosis factor(TNF), interleukin-6(IL-6) and interleukin-1(IL-1) in the study group were lower than those in the control group(P<0.05). After treatment, the levels of CD3^(+), CD4^(+), CD8^(+), CD4^(+)/CD8^(+)in the study group were higher than those in the control group(P<0.05). Patients with higher macrophage secretory function and lower T lymphocyte subsets have a higher probability of severe infection(P<0.05). There was a positive correlation between macrophage secretory function and trauma infection(P<0.05;OR>1), there was a negative correlation between T lymphocyte subsets and trauma infection(P<0.05;OR<1), the treatment method of the study group was the best(P<0.05;OR>1). Conclusion: Astragalus polysaccharide combined with ibuprofen is more effective in the treatment of patients with traumatic infection, the levels of macrophage secretory function and T lymphocyte subsets are the influencing factors of traumatic infection.