摘要
目的探讨山莨菪碱联合乌司他丁对严重多发创伤患者血清炎症因子肿瘤坏死因子α(TNF-α)和白细胞介素(IL)-6水平影响。方法将248例严重多发创伤患者随机分为4组,其中常规治疗组60例、山莨菪碱治疗组61例、乌司他丁治疗组62例、联合用药治疗组65例。四组患者入院均给予止血输血输液、抗感染、维持水电解质及酸碱平衡、营养支持以及呼吸循环支持等常规治疗措施;山莨菪碱治疗组在常规治疗基础上加用山莨菪碱10 mg静脉滴注,连续用药5 d;乌司他丁治疗组在常规治疗基础上加用乌司他丁20万单位+0.9%氯化钠溶液250 ml静脉滴注,1次/12 h,连续用药5 d:联合用药治疗组在常规治疗基础上加用山莨菪碱和乌司他丁静脉滴注,剂量和疗程同上两组。治疗前后采用双抗夹心法检测四组血清TNF-α和IL-6水平。结果四组治疗后血清TNF-α和IL-6水平均明显低于治疗前,且联合用药治疗组改善程度明显优于常规治疗组(P<0.01)。结论山莨菪碱联合乌司他丁对严重多发创伤患者能显著抑制炎性因子TNF-α和IL-6表达。
Objective To study the effect of anisodamine combined with ulinastatin on serum levels of inflammatory factors TNF-α and IL-6 in patients with severe multiple trauma.Methods A total of 248 patients with severe multiple trauma were randomly divided into 4 groups： 60 cases in conventional treatment group,61 cases in anisodamine treatment group,62 cases in ulinastatin treatment group and 65 cases in combination treatment group.Patients in these four groups were given with same therapeutic method for primary injury including hemostasia,blood transfusion,control of secondary infection,maintaining water and electrolyte balance and acid-base equilibrium,nutritional support,maintaining respiratory and circulatory support etc routine treatment.Patients in anisodamine group were additionally intravenously administrated with anisodamine 10 mg for 5 successive days.Patients in ulinastatin treatment group were intravenously given with ulinastatin 200000 units in 250 ml normal saline,once every 12 hours per day for 5 successive days.Patients in combination treatment group were additionally given with anisodamine and ulinastatin intravenous infusion.Dosage and duration of therapeutic course were same as above mentioned two groups.Serum levels of TNF-α and IL-6 were detected with double antibody sandwich assay in patients of these 4 groups before and after treatment.Results After treatment,serum levels of TNF-α and IL-6 in patients of 4 groups were significantly decreased in comparison with those before treatment,and they were significantly improved in combination treatment group than those of conventional treatment group（P0.01）.Conclusion The application of anisodamine combined with ulinastatin can significantly inhibit the expression of inflammatory factors TNF-α and IL-6 in patients with severe multiple trauma.
出处
《临床和实验医学杂志》
2012年第19期1533-1535,共3页
Journal of Clinical and Experimental Medicine
