参附注射液治疗严重脓毒症临床疗效及对血清IL-6、IL-10水平的影响

作者	单位
邱泽亮	温州医学院附属第六医院重症医学科
叶一萍	温州医学院附属第六医院重症医学科
张宁	温州医学院附属第六医院重症医学科
刘建华	温州医学院附属第六医院重症医学科

摘要点击次数: 1643

全文下载次数: 4

中文摘要:

目的观察参附注射液治疗严重脓毒症的临床疗效及其对血清IL-6和IL-10水平的影响。方法将68例严重脓毒症患者随机分为参附注射液加常规治疗组(简称参附组,36例)和常规治疗组(简称对照组,32例)。分别于治疗前及治疗后3、7天进行急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分和Marshall评分,评价其临床疗效并比较28天病死率,采用酶联免疫吸附法(ELISA)测定血清IL-6、IL-10水平;采用免疫投射比浊法测定C反应蛋白(C-reactive protein,CRP)。结果两组患者治疗前APACHEⅡ评分、Marshall评分、IL-6、IL-10及CRP水平比较,差异无统计学意义(P>0.05)。治疗后两组患者APACHEⅡ评分及Marshall评分均有下降(P<0.05),但参附组下降更明显(P<0.05)。参附组和对照组的病死率分别为25.0%(9/36)和37.5%(12/32),两组比较,差异无统计学意义(P>0.05)。治疗7天后两组血清IL-6及CRP水平均明显下降(P<0.05),但参附组下降幅度更大,与对照组比较,差异有统计学意义(P<0.05);而两组血清IL-10水平治疗前后无明显变化(P>0.05)。结论参附注射液能够降低血清促炎介质IL-6水平,调节严重脓毒症患者促炎/抗炎因子的平衡,从而起到改善临床疗效的作用。

英文摘要:

Objective To observe the therapeutic efficacy of Shenfu Injection(SFI) on patients with severe sepsis and its effects on serum levels of interleukin-6(IL-6) and interleukin-10(IL-10) .Methods Sixty-eight patients with severe sepsis were randomly assigned to the SFI group(36 cases,treated by SFI+routine therapy) and the control group(32 cases,treated by routine therapy) .The acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score and Marshall score were observed before treatment,3 and 7days after treatment.The therapeutic efficacy was assessed,and the 28th-day mortality rates were compared.The serum levels of IL-6 and IL-10 were determined by enzyme-labeled immunosorbent assay(ELISA) before and after treatment.C-reactive protein(CRP) was determined by immunoturbidimetric assay.Results There was no significant difference in the APACHE Ⅱ score,Marshall score,IL-6,IL-10,or CRP between the two groups before treatment(P>0.05) .APACHE Ⅱ score and Marshall score of all patients decreased after treatment,with more obvious decrease shown in the SFI group(P<0.05) .The mortality rate in the SFI group and the control group was 25.0%(9/36) and 37.5%(12/32) respectively,with no significant difference shown between the two groups(P>0.05) .The serum levels of IL-6 and CRP obviously decreased after 7 days of treatment(P<0.05) .But more decrement was shown in the SFI group,showing significant difference when compared with the control group(P<0.05) .There was no significant difference in the serum IL-10 level between the two groups before and after treatment(P>0.05) .Conclusion SFI could lower the serum IL-6 level,regulate the equilibrium of proinflammatory factors and anti-inflammatory cytokines in severe sepsis patients,thus playing a role in improving the therapeutic efficacy.

关闭