目的 探讨胸腺肽α1 在严重脓毒症中的应用价值.方法 选取2014年9月～2016年10月在浙江省肿瘤医院治疗的严重脓毒症患者94 例,将患者随机分为观察组(n =45)和对照组(n =49),对照组给予常规治疗,观察组在常规治疗的基础给予胸腺肽α1,观察2 组治疗前后T 细胞亚群、CD14+单核细胞人类白细胞抗原(HLA-DR)等变化.结果 观察组呼吸机使用时间和ICU治疗时间分别为(12.51 ±3.82)d 和(15.81 ±3.18)d,明显短于对照组( P <0.05);观察组和对照组28 d病死率比较差异无统计学意义;观察组治疗后CD14+单核细胞HLA-DR、CD3+和CD4+T细胞较治疗前明显改善( P <0.05);观察组治疗后HLA-DR、CD3+和CD4+分别为(36.04±8.90)％、(58.93±8.74)％和(43.20±9.90)％,明显高于对照组( P <0.05);观察组治疗后肿瘤坏死因子(TNF-α)、内毒素和C反应蛋白(CRP)分别为(56.40±11.78)ng/L、(27.83±9.98)ng/L和(53.20±9.73)g/mL,明显低于对照组 ( P < 0.05).结论 严重脓毒症治疗中应用胸腺肽α1,可改善患者细胞免疫功能,调节炎症反应状态,缩短机械通气时间和ICU住院时间.
The clinical significance of thymopeptides α1 in the treatment of severe sepsis
Objective To investigate the application values of thymosin α1 in severe sepsis.Methods Selected 94 patients with severe sepsis in our hospital from September 2014 to October 2016,were randomly divided into observation group(n=45)and control group(n=49),the control group was given routine treatment,the observation group was given thymosin α1 on the basis of conventional treatment,observed two groups before and after treatment T cell subsets and CD14+monocyte human leukocyte antigen(HLA-DR)and so on.Results The observation group the duration of ventilator use and ICU treatment were(12.51±3.82)d and(15.81±3.18)d,significantly shorter than the control group(P< 0.05).There was no significant difference in 28d mortality between the observation group and the control group; After treatment,the CD14+monocytes HLA-DR,CD3+and CD4+T cells in the observation group were significantly improved than before treatment(P<0.05);The HLA-DR,CD3+and CD4+T cells in the observation group after treatment were(36.04± 8.90)％,(58.93±8.74)％and(43.20±9.90)％,significantly higher than those in the control group(P<0.05);The observation group after treatment TNF-α,endotoxin and CRP respectively(56.40±11.78)ng/L,(27.83±9.98)ng/L and(53.20±9.73)g/mL,significantly lower than the control group(P< 0.05).Conclusion Application of thymosin α1 in the treatment of severe sepsis,which can improve the cellular immune function,adjust the state of inflammatory response,shorten the duration of mechanical ventilation and ICU stay.
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维普
