参附注射液对老年脓毒症患者免疫功能的影响

Effect of Shenfu injection on immune function in elderly patients with sepsis

目的:探讨参附注射液对于老年脓毒症患者相关免疫功能的影响。方法:回顾性纳入2019年1月至2020年12月间上海交通大学医学院附属瑞金医院等4所医院收治的老年脓毒症患者126例,按照是否应用参附注射液分为2组,其中参附组61例,对照组65例。收集基本资料、合并症、相关检验检查结果(包括炎症因子、体液免疫指标、细胞免疫指标等)、疾病严重程度评分、死亡率等,进行分析。结果:治疗7 d后2组患者的平均动脉压(mean artery pressure,MAP)、乳酸(lactate,Lac)、C反应蛋白(C⁃reactive protein,CRP)、降钙素原(procalcitonin,PCT)、凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、白介素⁃6(interleukin⁃6,IL⁃6)、IL⁃10、肿瘤坏死因子⁃α(tumor necrosis factor⁃α,TNF⁃α)、CD3计数、CD4计数、CD8计数、IgG、IgA、IgM水平均有明显改善(均P<0.05)。治疗后,参附组MAP较对照组升高更为显著(P=0.034),CD3(P=0.002)和CD4(P=0.002)绝对计数升高较对照组更为显著。结论:参附注射液联合标准集束化方案治疗老年脓毒症患者,可改善患者免疫功能,减轻炎症反应。

Objective To explore the effect of Shenfu injection on immune function in elderly patients with sepsis.Methods This study was a retrospective analysis.The elderly patients(n=126)with sepsis admitted to 4 hospitals including Shanghai Ruijin Hospital from January 2019 to December 2020 were divided into two groups according to whether Shenfu injection was used(61 cases in Shenfu group,65 cases in control group).Basic data,comorbidities,relevant test results(including inflammatory factors,humoral immune indicators,cellular immune indicators,etc.),disease severity score,mortality rate,etc.,were collected for statistical analysis.Results After seven days of Shenfu injection treatment,the indexes including the mean artery pressure(MAP),lactate(Lac),C⁃reactive protein(CRP),procalcitonin(PCT),prothrombin time(PT),activated partial thromboplastin time(APTT),interleukin⁃6(IL⁃6),IL⁃10,tumor necrosis factor⁃α(TNF⁃α),CD3 count,CD4 count,CD8 count,IgG,IgA and IgM of patients in 2 groups were significantly improved(all P<0.05).Compared with the control group,MAP(P=0.034),and the absolute count of CD3(P=0.002)and CD4(P=0.002)were significantly increased in the Shenfu treated group.Conclusions Shenfu injection combined with standard bundled regimen can improve the immune function and reduce inflammation in elderly patients with sepsis.