乌司他丁联合丹红注射液对脓毒症患者的疗效以及对sTREM-1、HBP水平及th17/treg的影响

doi:10.3969/j.issn.1007-3205.2020.08.008

河北医科大学学报

乌司他丁联合丹红注射液对脓毒症患者的疗效以及对sTREM-1、HBP水平及th17/treg的影响

1.南京医科大学附属淮安第一医院急诊科，江苏淮安 223000；2 南京医科大学附属淮安第一医院ICU，
江苏淮安 223000；3.南京医科大学附属第一医院急诊中心，江苏南京 210029

出版日期:2020-08-25 发布日期:2020-08-26
作者简介:常青（1987-），男，江苏淮安人，南京医科大学附属淮安第一医院医师，医学学士，从事急救医学研究。

Effects of ulinastatin combined with Danhong injection on the level of STREM-1and HBP, Th17/Treg and clinical efficacy in sepsis patients

1.Department of Emergency，Huai'an First Hospital Affiliated to Nanjing Medical University, Jiangsu
Province， Huai′an 223000，China； 2.Internsive Care Unit, Huai′an First Hospital Affiliated to Nanjing
Medical University， Jiangsu Province， Huai′an 223000， China； 3.Emergency Center, the First
Affiliated Hospital of Nanjing Medical University， Jiangsu Province， Nanjing 210029， China

Online:2020-08-25 Published:2020-08-26

摘要/Abstract

摘要： 目的乌司他丁联合丹红注射液对脓毒症患者的疗效以及对可溶性髓样细胞触发受体1(soluble triggering receptor exprssed on myeloid cells 1,sTREM-1）、肝素结合蛋白（heparin-bindingprotein,HBP）水平和辅助性T细胞17(T help cell 17,Th17)/调节性T细胞(T regular cell,Treg)的影响。
方法选取脓毒症患者120例，根据随机数字表法分为对照组和观察组各60例。对照组采用常规方式联合乌司他丁治疗，观察组在对照组基础上注射丹红注射液。比较两组治疗后的临床疗效，治疗前后急性生理学与慢性健康状况（Acute Physiology And Chronic Health Evaluation Ⅱ，APACHEⅡ）评分、血清HBP和sTREM-1水平、T细胞亚群、凝血功能指标及不良反应情况。
结果治疗7 d后，观察组有效率为90.00%（54/60），明显高于对照组75.00%（45/60），差异有统计学意义(χ2=4.490，P=0.034)。两组APACHEⅡ评分组间、时点间和组间·时点间比较差异均有统计学意义（P＜0.05）。治疗后，两组血清HBP和sTREM-1水平低于治疗前（P＜0.05），观察组血清HBP和sTREM-1水平显著低于对照组（P＜0.05或P＜0.01）。治疗后，两组Th17和Treg（CD4+ CD25+、CD4+ CD25high）表达率显著低于治疗前（P＜0.05），观察组Th17和Treg（CD4+ CD25+、CD4+ CD25high）表达率显著低于对照组（P＜0.05或P＜0.01）。治疗后，两组较治疗前血小板计数(platelet count，PLT)和纤维蛋白原(fibrinogen，FIB)均升高，凝血酶原时间(prothrombin time，PT)、活化部分凝血活酶时间(activated partial thromboplastin time，APTT)和凝血酶时间(thrombin time，TT)均降低（P＜0.05）；观察组较对照组PLT和FIB均显著升高，PT、APTT和TT均显著降低（P＜0.01）。两组不良反应发生率差异无统计学意义（χ2=0.260,P=0.609）。
结论乌司他丁联合丹红注射液对脓毒症患者的疗效显著，能够有效调节sTREM-1、HBP水平及Th17/Treg表达率，改善免疫、凝血功能，促进预后。

关键词: 脓毒症, 乌司他丁, 丹红注射液

Abstract: Objective To investigate the effect of ulinastatin combined with Danhong injection on the level of soluble triggering receptor exprssed on myeloid cells-1(STREM-1) and heparin-bindingprotein(HBP), T help cell 17(Th17)/T regular cell(Treg) and clinical efficacy in sepsis patients.
Methods A total of 120 patients with sepsis were selected and divided into control group and observation group according to the method of random number table, 60 cases each. The control group was treated with routine method combined with ulinastatin, and the observation group was injected with Danhong injection on the basis of the control group. The clinical efficacy of the two groups after treatment, Acute Physiology and Chronic Health Evaluation Ⅱ(APACHEⅡ) score, serum HBP and sTREM-1 levels, T cell subsets, coagulation function indexes and adverse reactions were compared before and after treatment.
Results After 7 d of treatment, the effective rate of the observation group was 90.00%(54/60), which was significantly higher than that of the control group 75.00%(45/60), and the difference was statistically significant(χ2=4.490, P=0.034). There were significant differences in APACHEⅡ scores between two groups at different time points(P＜0.05). The serum HBP and sTREM-1 levels in two groups were lower than before treatment(P＜0.05), and the serum HBP and sTREM-1 levels in the observation group were significantly lower than those in the control group(P＜0.05 or P＜0.01). The expression rate of Th17 and Treg（CD4+CD25+, CD4+CD25high） in the two groups was significantly lower than that before treatment(P＜0.05). The expression rate of Th17 and Treg(CD4+CD25+, CD4+CD25high) in the observation group was significantly lower than that in the control group(P＜0.05 or P＜0.01). After treatment, platelet count(PLT) and fibrinogen(FIB) of two groups were increased, prothrombin time(PT), activated partial thromboplastin time(APTT) and thrombin time(TT) were decreased(P＜0.05); PLT and FIB of the observation group were significantly higher than those of control group, PT, APTT and TT were significantly decreased(P＜0.01). There was no significant difference in the incidence of adverse reactions between two groups(χ2=0.260, P=0.609).
Conclusion Ulinastatin combined with Danhong injection has significant curative effect on sepsis patients. It can effectively regulate sTREM-1, HBP levels and Th17/Treg expression rate, improve immune and coagulation functions, and promote prognosis.

Key words: sepsis, ulinastatin, Danhong injection

常青, 陈豆豆, 吴魏芹, 张劲松. 乌司他丁联合丹红注射液对脓毒症患者的疗效以及对sTREM-1、HBP水平及th17/treg的影响[J]. 河北医科大学学报, doi: 10.3969/j.issn.1007-3205.2020.08.008.

CHANG Qing, CHEN Dou-dou, WU Wei-qin, ZHANG Jin-song. Effects of ulinastatin combined with Danhong injection on the level of STREM-1and HBP, Th17/Treg and clinical efficacy in sepsis patients[J]. Journal of Hebei Medical University, doi: 10.3969/j.issn.1007-3205.2020.08.008.

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乌司他丁联合丹红注射液对脓毒症患者的疗效以及对sTREM-1、HBP水平及th17/treg的影响

Effects of ulinastatin combined with Danhong injection on the level of STREM-1and HBP, Th17/Treg and clinical efficacy in sepsis patients

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