摘要
目的观察参麦注射液对胸外科手术患者预后的临床疗效及安全性。方法将48例胸外科手术患者随机分为对照组24例和试验组24例。对照组于围手术期给予常规治疗;试验组在对照组治疗的基础上,于麻醉诱导后予以静脉滴注参麦注射液50 mL qd,连续给药5 d。比较2组患者术前和术后1,4,48,120 h血清白细胞介素-6(IL-6)、IL-8、补体C_3、C_4的变化、免疫功能,以及药物不良反应的发生情况。结果术后1,4,48,120 h,试验组的IL-6分别为(124.58±29.12),(90.26±15.83),(29.17±4.21)和(16.53±2.02)pg·mL^(-1),对照组的IL-6分别为(398.56±56.22),(239.68±34.23),(148.52±18.93)和(96.43±14.63)pg·mL^(-1);试验组的IL-8分别为(16.19±5.24),(9.26±3.13),(4.38±1.42)和(3.43±1.14)pg·mL^(-1),对照组的IL-8分别为(24.57±6.33),(19.79±3.17),(148.52±18.92)和(96.4±14.63)pg·mL^(-1),2组术后各时点的IL-6和IL-8比较,差异均有统计学意义(均P<0.05)。术前和术后1,4,48,120 h,试验组的补体C_3分别为(1.12±0.47)%,(0.85±0.22)%,(0.80±0.26)%,(0.78±0.19)%和(0.77±0.14)%,对照组的补体C_3分别为(1.10±0.47)%,(0.61±0.28)%,(0.76±0.24)%,(0.83±0.21)%和(0.81±0.16)%;试验组的补体C_4分别为(0.49±0.27)%,(0.31±0.16)%,(0.35±0.14)%,(0.36±0.17)%和(0.35±0.15)%,对照组的补体C_4分别为(0.51±0.28)%,(0.37±0.21)%,(0.32±0.18)%,(0.39±0.14)%和(0.37±0.16)%,且2组术后各时点的补体C_3和C_4水平与术前比较,差异均有统计学意义(均P<0.05)。术前和术后1,4,48,120 h,试验组的CD_3^+分别为(69.87±2.34)%,(60.49±2.18)%,(54.17±1.78)%,(52.46±1.79)%和(51.41±1.79)%,对照组的CD_3^+分别为(70.12±2.47)%,(53.18±2.19)%,(52.52±1.79)%,(50.79±2.09)%和(50.31±1.72)%;试验组的CD_4^+分别为(43.04±3.85)%,(35.46±2.56)%,(32.17±1.98)%,(29.59±2.14)%和(29.21±2.11)%,对照组的CD_4^+分别为(42.93±2.51)%,(32.73±2.28)%,(30.41±2.04)%,(31.14±1.89)%和(30.57±2.16)%;试验组的CD_4^+/CD_8^+分别为(1.57±0.39),(1.40±0.41),(1.39±0.37),(1.37±0.35)和(1.38±0.36),对照组的CD_4^+/CD_8^+分别为(1.56±0.43),(1.24±0.29),(1.33±0.25),(1.36±0.28)和(1.39±0.34),且2组患者术后各时点的CD_3^+、CD_4^+、CD_4^+/CD_8^+水平与术前比较,差异均有统计学意义(均P<0.05)。2组患者治疗过程中未出现严重药物不良反应。结论参麦注射液可明显提高胸外科患者术后的恢复效果,降低患者的炎症因子和补体C_3、C_4水平,改善患者的免疫功能,且安全性较高。
Objective To study the clinical effect and safety of Shenmai injection on the prognosis of thoracic surgery patients. Methods Atotal of 48 patients with thoracic surgery were randomly divided into control group and treatment group with 24 cases per group. Conventional perioperative treatment was taken for both of them. While the treatment group had additional application of Shenmai injection,which was given by intravenous infusion,50 mL,qd,after anesthesia induction,and was continuously used for 5 d. The serum levels of interleukin-6（ IL-6）,IL-8,complement C3,complement C4,immunologic function,and adverse drug reactions at the time of preoperative and postoperative 1,4,48,120 h were compared between two groups. Results After operative 1,4,48,120 h,the levels of IL-6 in treatment group were（ 124. 58 ± 29. 12）,（ 90. 26 ± 15. 83）,（ 29. 17 ± 4. 21） and（ 16. 53 ± 2. 02） pg·mL^-1; while in the control group were（ 398. 56 ± 56. 22）,（ 239. 68 ± 34. 23）,（ 148. 52 ± 18. 93） and（ 96. 43 ± 14. 63） pg · mL^-1. The level of IL-8 in treatment group were（ 16. 19 ± 5. 24）,（ 9. 26 ± 3. 13）,（ 4. 38 ± 1. 42） and（ 3. 43 ± 1. 14） pg · mL^-1;while IL-8 of the control group were（ 24. 57 ± 6. 33）,（ 19. 79 ± 3. 17）,（ 148. 52 ± 18. 92） and（ 96. 4 ± 14. 63）pg·mL^-1. The differences of The IL-6 and IL-8 in the two groups at each time point after the operation were statistically significant（ all P〈0. 05）. At the time of before operative and after perative 1,4,48,120 h,the level of complement C3 in the treatment group were（ 1. 12 ± 0. 47） %,（ 0. 85 ± 0. 22） %,（ 0. 80 ± 0. 26） %,（ 0. 78 ± 0. 19） % and（ 0. 77 ± 0. 14） %; while in control group were（ 1. 10 ± 0. 47） %,（ 0. 61 ± 0. 28） %,（ 0. 76 ± 0. 24） %,（ 0. 83 ± 0. 21） % and（ 0. 81 ± 0. 16） %. The level of C4 in the treatment group were（ 0. 49 ± 0. 27） %,（ 0. 31 ± 0. 16） %,（ 0. 35 ± 0. 14） %,（ 0. 36 ± 0. 17） % and（ 0. 35 ± 0. 15） %; while in the control group were（ 0. 51 ± 0. 28） %,（ 0. 37 ± 0. 21） %,（ 0. 32 ± 0. 18） %,（ 0. 39 ± 0. 14） % and（ 0. 37 ± 0. 16） %.Compared with after operative level,the differences of C3 and C4 level in the two groups at each time point of postoperative were statistically significant（ all P〈0. 05）. At the time of before operative and after operative 1,4,48,120 h.The level of CD＋3 in treatment group were（ 69. 87 ± 2. 34） %,（ 60. 49 ± 2. 18） %,（ 54. 17 ± 1. 78） %,（ 52. 46 ± 1. 79） % and（ 51. 41 ± 1. 79） %; while in the control group were（ 70. 12 ± 2. 47） %,（ 53. 18 ± 2. 19） %,（ 52. 52 ± 1. 79） %,（ 50. 79 ± 2. 09） % and（ 50. 31 ± 1. 72） %. The level of CD4~＋in the treatment group were（ 43. 04 ± 3. 85） %,（ 35. 46 ± 2. 56） %,（ 32. 17 ± 1. 98） %,（ 29. 59 ± 2. 14） % and（ 29. 21 ± 2. 11） %; while in the control group were（ 42. 93 ± 2. 51） %,（ 32. 73 ± 2. 28） %,（ 30. 41 ± 2. 04） %,（ 31. 14 ± 1. 89） % and（ 30. 57 ± 2. 16） %. CD4~＋/CD8~＋in the treatment group were（ 1. 57 ± 0. 39）,（ 1. 40 ± 0. 41）,（ 1. 39 ± 0. 37）,（ 1. 37 ± 0. 35） and（ 1. 38 ± 0. 36）,while in the control group,they were（ 1. 56 ± 0. 43）,（ 1. 24 ± 0. 29）,（ 1. 33 ± 0. 25）,（ 1. 36 ± 0. 28） and（ 1. 39 ± 0. 34）. Compared with postoperative level,the differences of CD＋3,CD＋4,CD＋4/CD＋8 level in the two groups at each time point of postoperative were statistically significant（ all P〈0. 05）. Both of the two groups had no severe adverse drug reactions in the study. Conclusion Shenmai injection can significantly improve the therapeutic effect of the patients with thoracic surgery,which can improve the patient＇ s immune function and reduce patients level of inflammatory cytokines and complement C3 and C4,without increasing the incidence of adverse drug reactions.
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2017年第21期2124-2126,2142,共4页
The Chinese Journal of Clinical Pharmacology
基金
浙江省医学会临床科研基金资助项目(2013ZYC-A75)
关键词
参麦注射液
胸外科手术
补体水平
免疫功能
炎症因子
Shenmai injection
thoracic surgery
complement level
immune function
inflammatory factor
