摘要目的 研究川芎嚓、乌司他丁和胸腺肽α1对脓毒症患者的免疫调理及保护作用.方法 90例脓毒症患者随机分为三组,包括ICU治疗组、川芎嚓治疗组、乌司他丁和胸腺肽α1治疗组.观察各组HLADR/CD14+、Lac、IL-6、TNF-α、D-二聚体等指标的变化.结果 (1)ICU治疗组和乌司他丁和胸腺肽α1治疗组各时间点D-二聚体无明显变化(P＞0.05).川芎嗪治疗组D-二聚体呈下降趋势,在3 d时,与其他两组差异有统计学意义(P＜0.05).(2)ICU组各时间点乳酸值无明显变化(P＞0.05).川芎嚷组和乌司他丁和胸腺肽α1治疗Lac组呈降低趋势,在第2天这两组与ICU组差异有统计学意义(P＜0.05).(3)在IL-6、TNF-α的变化方面,ICU组各时间点呈上升趋势(P＜0.05).治疗后第3天,乌司他丁和胸腺肽α1治疗组IL-6、TNF-α恢复治疗前水平,HLA-DR/CD14+值上升显著,与川芎嗪组、ICU治疗组比较,差异有统计学意义(P＜0.05).结论 川芎嗪主要作用是改善局部微循环,降低乳酸和防止微血栓的形成,乌司他丁、胸腺肽α1对脓毒症患者的免疫具有保护作用,与抑制IL-6、TNF-a细胞因子的作用有关.

abstractsObjective To investigate the effect of microcireulation blood flow and altering immunity by Chuanxiongqin,ulinastain and thymosin α1 on sepsis patients.Methods 90 patients were randomly divided into 3 groups(n=30),namely ICU group,Chuanxiongqin group,ulinastain and thymosin α1 group.HLA-DR/CD14+and IL-6,TNF-α,Lac,DD were measured.Results (1)DD showed no significant difference at every time point between ICU group and ulinastain+thymosin α1 group(P＞0.05).DD decreased in Chuanxiongqin group,and was significantly different from the others on the third day.(2)Lac unchanged significantly at every time point in ICU group(P＞0.05).Lac in Chuanxiongqin group and ulinastain+thymeain α1 group tended to decrease,and was statistically different from ICU group on the second day.(3)IL-6 and TNF-α tended to increase at every time point in ICU group(P＜0.05).In ulinastain+thymosin α1 group,IL-6 and TNF-α returned to the level before treatment,HLA-DR/(D14+increased significantly,and was higher than Chuanxiongqin group and ICU group statistically.Conclusion Chuanxiongqin could ameliorate circulation;ulinastsin and thymosin α1 could depress IL-6,TNF-α.So ulinastain and thymosin α1 might protect the immunity of sepsis patients.