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目的探讨对严重创伤患者行参附注射液后外周血T细胞亚群和天然杀伤细胞(NK细胞)的变化,从而观察其对ICU治疗时间、多器官功能障碍综合征(MODS)发生率及病死率的影响。方法将60例严重创伤患者随机分为对照组(30例)和参附治疗组(30例),同期选取30例健康体检者为健康对照组。对照组患者给予常规诊治,参附治疗组患者则在常规救治的基础上早期加用参附注射液治疗。采用流式细胞技术测定患者治疗前、治疗后3 d和7 d的外周血T细胞亚群的CD3~+、CD4~+、CD8~+和NK细胞的数量。并观察2组重症监护病房(ICU)治疗时间、MODS发生率及病死率。结果两治疗组CD3~+、CD4~+、CD8~+和NK细胞及CD4~+/CD8~+比值明显低于健康对照组(P<0.05)。治疗3 d,参附组CD3~+、CD4~+、CD8~+和NK细胞及CD4~+/CD8~+比值均明显升高(P<0.05)。治疗7 d,两治疗组CD3~+、CD4~+、CD8~+和NK细胞及CD4~+/CD8~+比值均明显升高(P<0.05)。参附组CD3~+、CD4~+、CD8~+和NK细胞及CD4~+/CD8~+比值明显高于对照组(P<0.05)。参附组ICU治疗时间、MODS发生率、病死率均明显低于对照组(P<0.05)。结论严重创伤患者在常规救治的基础上早期使用参附注射液,明显改善T细胞亚群和NK细胞的免疫障碍,从而缩短ICU住院时间,降低多器官功能障碍综合征发生率及病死率。
Objective To investigate the changes of peripheral blood T lymphocyte subsets and natural killer cells (NK cells) in patients with severe trauma after Shenfu injection, and to observe the effect of ICU treatment time, incidence of multiple organ dysfunction syndrome (MODS) and death Rate of impact. Methods Sixty patients with severe trauma were randomly divided into control group (30 cases) and Shenfu treatment group (30 cases). 30 healthy subjects were selected as healthy control group in the same period. Patients in the control group were given routine diagnosis and treatment, and patients in the treatment group received treatment with Shenfu injection early on the basis of routine treatment. The numbers of CD3 +, CD4 +, CD8 + and NK cells in T lymphocyte subsets of peripheral blood before treatment, 3 d and 7 d after treatment were determined by flow cytometry. The ICU treatment time, the incidence of MODS and the mortality were observed in two ICU groups. Results The ratio of CD3 ~ +, CD4 ~ +, CD8 ~ +, NK cells and CD4 ~ + / CD8 ~ + in two treatment groups were significantly lower than those in healthy control group (P <0.05). After 3 days of treatment, the ratio of CD3 ~ +, CD4 ~ +, CD8 ~ + and NK cells and the ratio of CD4 ~ + / CD8 ~ + in Shenfu group were significantly increased (P <0.05). After 7 days of treatment, the ratios of CD3 ~ +, CD4 ~ +, CD8 ~ +, NK cells and CD4 ~ + / CD8 ~ + were significantly increased in the two treatment groups (P <0.05). The ratio of CD3 ~ +, CD4 ~ +, CD8 ~ + and NK cells and the ratio of CD4 ~ + / CD8 ~ + in the reference group were significantly higher than those in the control group (P <0.05). Reference group ICU treatment time, MODS incidence, mortality were significantly lower than the control group (P <0.05). Conclusion Severe trauma patients use Shenfu injection early on the basis of routine treatment, which can obviously improve immune disorders of T cell subsets and NK cells, shorten ICU length of hospital stay and reduce the incidence of multiple organ dysfunction syndrome and mortality.