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目的:探讨乌司他丁联合胸腺肽α1对急性颅脑损伤患者免疫功能的影响。方法:急性颅脑损伤患者68例随机分为对照组与联合组各34例。对照组患者行常规治疗,联合组患者在对照组基础上加用乌司他丁联合胸腺肽α1治疗。分别于治疗后1,3,7,14 d检测两组患者转化生长因子-β1(TGF-β1)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)等血清炎症细胞因子水平,及CD4~+、CD8~+、CD4~+/CD8~+、人类白细胞DR抗原(HLA-DR)等细胞免疫指标水平;借助颅脑损伤预后恢复分级法评定两组患者预后效果,并对两组不良反应情况进行分析。结果:治疗后1 d两组患者血清炎症细胞因子及免疫指标水平比较差异均无统计学意义(P>0.05)。治疗后3,7,14 d两组患者血清TGF-β1、IL-6、IL-10、TNF-α水平均明显高于治疗后1 d水平(P<0.05);随时间延长,TGF-β1水平呈现升高趋势,IL-6、IL-10、TNF-α及CD4~+、CD4~+/CD8~+呈现先升高后降低的趋势,CD8~+、HLA-DR呈现先降低后升高的趋势;联合组治疗后3,7,14 d血清IL-10、CD4~+水平明显高于对照组,IL-6及TNF-α水平明显低于对照组(P<0.05),治疗后3,14 d时CD8~+水平明显高于对照组,治疗后7,14 d时HLA-DR水平明显高于对照组(P<0.05)。联合组患者预后情况好于对照组(P<0.05)。结论:急性颅脑损伤患者使用乌司他丁联合胸腺肽α1治疗,细胞免疫功能改善及预后效果均较好,值得临床推广应用。
Objective: To investigate the effects of ulinastatin combined with thymosin α1 on immune function in patients with acute craniocerebral injury. Methods: 68 patients with acute craniocerebral injury were randomly divided into control group and combination group of 34 cases. Patients in the control group underwent routine treatment. Patients in the combination group were treated with ulinastatin and thymosin α1 on the basis of the control group. The levels of transforming growth factor-β1 (TGF-β1), interleukin-6 (IL-6), interleukin-10 (IL-10) Serum levels of inflammatory cytokines, such as TNF-α, and cellular immune indexes such as CD4 ~ +, CD8 ~ +, CD4 ~ + / CD8 ~ + and human leukocyte DR antigen (HLA-DR) Prognosis of brain injury recovery grading method to assess the prognosis of two groups of patients, and two groups of adverse reactions were analyzed. Results: There was no significant difference in serum inflammatory cytokines and immune indexes between the two groups on the first day after treatment (P> 0.05). The levels of TGF-β1, IL-6, IL-10 and TNF-α in the two groups at 3, 7 and 14 days after treatment were significantly higher than those at 1 day after treatment (P <0.05) The levels of IL-6, IL-10, TNF-α, CD4 ~ + and CD4 ~ + / CD8 ~ + increased at first and then decreased, while the levels of CD8 ~ + and HLA- The levels of IL-10 and CD4 ~ + in the combined group were significantly higher than those in the control group on the 3rd, 7th, 14th and 14th days after treatment, and the levels of IL-6 and TNF-α in the combined group were significantly lower than those in the control group (P <0.05) The levels of CD8 + at 3 and 14 d were significantly higher than those in the control group. The levels of HLA-DR at 7 and 14 d after treatment were significantly higher than those in the control group (P <0.05). The prognosis of the combined group was better than that of the control group (P <0.05). Conclusion: Ulinastatin and thymosin α1 are used in patients with acute craniocerebral injury. The improvement of cellular immune function and prognosis are both good and worthy of clinical application.