乌司他丁联合血液净化对感染性休克患者炎性因子、心肌损伤、免疫指标的影响

Effect of Ulinastatin Combined with Blood Purification on Inflammatory Factors,Myocardial Injury and Immune Indexes in Patients with Septic Shock

讨论乌司他丁联合血液净化对感染性休克患者炎性因子、心肌损伤、免疫指标的影响。选择2016年3月~2019年4月该院ICU收治感染性休克患者129例,按照患者治疗方式差异分成3组,每组43例;A组患者采用常规治疗,B组采用常规治疗^(+)乌司他丁,C组采取常规治疗^(+)乌司他丁^(+)连续血液净化治疗;比较3组患者治疗后炎性因子、心肌损伤指标、免疫指标以及氧化指标的变化。治疗前,3组患者炎性因子、心肌损伤指标、免疫指标以及氧化指标的差异均不显著(P> 0.05);治疗后,C组患者MIP-2、MCP-1、c TNT、NT-proBNP、AOPP、CAT均明显低于A组(P <0.05),MIP-2、MCP-1、c TNT、NT-proBNP、CAT均明显低于B组(P <0.05),患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、T-AOC均明显高于A组(P <0.05),CD3^(+)、CD4^(+)、T-AOC明显高于B组(P <0.05)。乌司他丁联合血液净化能更有效地减轻患者炎症症状,抑制患者氧化应激反应,提高患者细胞免疫功能,保护患者心肌功能,临床应用价值高。

To discuss the effects of ulinastatin combined with blood purification on inflammatory factors,myocardial injury and immune indicators in patients with septic shock,129 patients with septic shock admitted to the anther’s hospital from March 2016 to April 2019 were divided into three groups based on the difference of treatment methods,with 43 cases in each group. The patients in group A received routine treatment,group B received routine treatment ^(+) Ulinastatin,and group C received routine treatment ^(+)Ulinastatin ^(+) continuous blood purification. 3 mL of fasting and peripheral venous blood were collected before treatment and 3 days after treatment. The upper serum was collected by centrifugation( 3000 r/min),and the serum indexes were tested. The levels of macrophage inflammatory protein-2( MIP-2),monocyte chemoattractant protein-1( MCP-1),troponin T( c Tn T) and N-terminal proB-type natriuretic peptide( NT pro BNP) were detected by enzyme-linked immunosorbent assay. T lymphocyte subsets( CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)) were detected by flow cytometry. The levels of AOPP,T-AOC and cat were detected by radioimmunoassay. The changes of the above indexes in different groups before and after treatment were compared and analyzed. Before treatment,there was no significant difference in inflammatory factors,myocardial injury index,immune index and oxidative index between the three groups( P > 0. 05);After treatment,MIP-2,MCP-1,c TNT,NT-proBNP,AOPP and CAT in the C group were significantly lower than those in the A group( P < 0. 05);MIP-2,MCP-1,c TNT,NT-proBNP and CAT were significantly lower than those in group B( P < 0. 05);The levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+),T-AOC in the observation group were significantly higher than those in the control group( P < 0. 05),CD3^(+),CD4^(+),T-AOC were significantly higher than group B( P < 0. 05). Ulinastatin combined with blood purification can more effectively alleviate inflammation symptoms,inhibit oxidative stress reaction,improve cellular immune function and protect myocardial function of patients. It has high clinical value.