乌司他丁对重症中暑急性肺损伤的作用及机制研究
目的观察乌司他丁对重症中暑急性肺损伤的临床疗效。方法30例重症中暑患者按随机数字表法分为常规治疗组和乌司他丁组，每组15例，另设健康对照组（n=8）。比较两组中暑患者人院时的年龄、性别、发病至接受治疗的时间以及APACHEⅡ评分等基线情况的差异，以及入院后第0、3、s天外周血白细胞计数，Murray评分和氧合指数的差别，并通过酶联免疫吸附法（ELISA）测定支气管肺泡灌洗液（BALF）与肺泡巨噬细胞培养上清炎症介质的浓度，采用免疫印迹法和实时定量PCR法检测肺泡巨噬细胞髓样细胞触发受体-1（TREM-1）表达情况。观察并比较两组患者的机械通气时间、ICU住院时间和28d病死率。结果两组患者人院...
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| Published in | Jie fang jun yi xue za zhi Vol. 42; no. 4; pp. 301 - 306 |
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| Main Author | |
| Format | Journal Article |
| Language | Chinese |
| Published |
Beijing
People's Military Medical Press
2017
515041广东汕头 汕头大学医学院%510010广州,广州军区广州总医院重症医学科、解放军热区创伤救治与组织修复重点实验室 523900广东东莞,东莞市第五人民医院重症医学科%523900广东东莞 东莞市第五人民医院重症医学科 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0577-7402 |
| DOI | 10.11855/j.issn.0577-7402.2017.04.06 |
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| Summary: | 目的观察乌司他丁对重症中暑急性肺损伤的临床疗效。方法30例重症中暑患者按随机数字表法分为常规治疗组和乌司他丁组，每组15例，另设健康对照组（n=8）。比较两组中暑患者人院时的年龄、性别、发病至接受治疗的时间以及APACHEⅡ评分等基线情况的差异，以及入院后第0、3、s天外周血白细胞计数，Murray评分和氧合指数的差别，并通过酶联免疫吸附法（ELISA）测定支气管肺泡灌洗液（BALF）与肺泡巨噬细胞培养上清炎症介质的浓度，采用免疫印迹法和实时定量PCR法检测肺泡巨噬细胞髓样细胞触发受体-1（TREM-1）表达情况。观察并比较两组患者的机械通气时间、ICU住院时间和28d病死率。结果两组患者人院时的年龄、性别、发病至接受治疗的时间以及APACHEⅡ评分差异无统计学意义（P〉0．05）。治疗后第3、5天，乌司他丁组外周血白细胞计数、Murray评分均低于常规治疗组（P〈0．05或P〈0．01），而氧合指数高于常规治疗组（P〈0．05）；BALF及肺泡巨噬细胞培养上清中的TNF-α和IL-6浓度均低于常规治疗组（P〈0．05或P〈0．01），肺泡巨噬细胞TREM-1mRNA和蛋白表达水平明显低于常规治疗组（P〈0．01或P〈0．05）。乌司他丁组重症中暑患者的机械通气时间和ICU住院时间明显低于常规治疗组（P〈0．01或P〈0．05），但28d病死率两组比较差异无统计学意义（P〉0．0S）。结论乌司他丁对重症中暑急性肺损伤具有良好的临床疗效，有利于减轻肺组织炎症反应程度，其机制可能与乌司他丁调控重症中暑肺泡巨噬细胞的炎症分泌活性及TREM-1表达有关。 |
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| Bibliography: | CHEN Yil, LUO Jia-jin1,3, JIANG Dong-xin1, LIN You-pingl, TONG Hua-sheng2, SU Lei2（ 1Department of Intensive Care Unit, the Fifth People＇s Hospital of Dongguan, Dongguan, Guangdong 523900, China 2Department of Intensive Care Unit, Guangzhou General Hospital of Guangzhou Command, Key Laboratory of Tropical Zone Care and Tissue Repair in PLAj Guangzhou 510010, China） heat stroke; ulinastatin; acute lung injury Objective To investigate the effect of ulinastatin on severe heat-stroke with acute lung injury induced by severe heat stroke. Methods Thirty severe heat stroke patients were divided into conventional group （n=15） and ulinastatin group （n=15） randomly, with another 80 healthy adults serving as controls. The baseline data such as age, gender, onset period and APACHE Ⅱ scores were recorded and compared between the two groups on admission. Peripheral leucocyte counts, oxygenation index and Murray scores were determined on the 1st, 3rd and 5th day. The concentration of inflammatory mediators in bronchoalveolar ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 |
| ISSN: | 0577-7402 |
| DOI: | 10.11855/j.issn.0577-7402.2017.04.06 |