摘要
目的探讨美罗培南治疗脓毒症休克对心型脂肪酸结合蛋白(H-FABP)、肠型脂肪酸结合蛋白(I-FABP)、半乳糖凝集素-3(Gal-3)水平的作用。方法选择2018年6月-2020年6月在河南科技大学第一附属医院接受治疗的80例脓毒症休克患者,采用随机数表法将其分为试验组(n=41)和对照组(n=39)。对照组给予氢化可的松治疗,试验组在对照组的基础上给予美罗培南治疗。比较2组细菌清除率、H-FABP、I-FABP、Gal-3、T淋巴细胞亚群(CD3^(+)、CD4^(+))和自然杀伤细胞(NK)水平;同时统计序贯器官衰竭(SOFA)评分、机械通气时间、住院时间、28 d病死率及并发症发生情况。结果试验组细菌清除率为92.68%,高于对照组的74.36%,差异有统计学意义(χ^(2)=4.931,P=0.026)。治疗前,2组H-FABP、I-FABP、Gal-3、CD3^(+)、CD4^(+)、NK水平、SOFA评分比较差异均无统计学意义(P均>0.05);治疗后,2组H-FABP、I-FABP、Gal-3水平、SOFA评分均降低,CD3^(+)、CD4^(+)、NK水平均升高,差异均有统计学意义(P均<0.05);且试验组H-FABP、I-FABP、Gal-3水平、SOFA评分低于对照组,CD3^(+)、CD4^(+)、NK水平高于对照组,差异均有统计学意义(P均<0.05)。试验组机械通气时间、住院时间[(7.38±0.71)、(12.68±2.08)d]显著低于对照组[(9.68±1.41)、(18.91±2.63)d],差异均有统计学意义(t=9.283、11.782,P均<0.05)。试验组28 d病死率(7.32%)显著低于对照组(23.08%),差异有统计学意义(χ^(2)=3.894,P=0.048)。试验组和对照组患者治疗期间并发症总发生率分别为9.76%、17.95%,差异无统计学意义(χ^(2)=1.131,P=0.288)。结论在脓毒症休克患者中应用美罗培南治疗疗效显著,可能与其可有效改善H-FABP、I-FABP、Gal-3水平有关。
Objective To investigate the effect of meropenem in the treatment of sepsis shock on hearttype-fatty acid binding protein(H-FABP),intestinal-fatty acid binding protein(I-FABP),galectin-3(Gal-3).Methods A total of 80 patients with septic shock treated in the First Affiliated Hospital of Henan University of Science and Technology from June 2018 to June 2020 were selected and divided into experimental group(n=41)and control group(n=39)by random number table method.The control group was treated with hydrocortisone,and the experimental group was treated with meropenem on the basis of the control group.The bacterial clearance rate,H-FABP,I-FABP,Gal-3,T lymphocyte subsets(CD3^(+),CD4^(+))and natural killer cell(NK)levels were compared between the two groups;at the same time,the sequential organ failure assessment(SOFA)score,mechanical ventilation time,days of hospitalization,28-day mortality and complications were calculated.Results The bacterial clearance rate of the experimental group was 92.68%,which was higher than that of the control group(74.36%),the difference was statistically significant(χ^(2)=4.931,P=0.026).Before treatment,there were no significant differences in H-FABP,I-FABP,Gal-3,CD3^(+),CD4^(+),NK levels and SOFA score between the experimental group and the control group(all P>0.05).After treatment,the levels of H-FABP,I-FABP,Gal-3 and SOFA score were decreased,while the levels of CD3^(+),CD4^(+)and NK were increased in both groups;the differences were statistically significant(all P<0.05).The levels of H-FABP,I-FABP,Gal-3 and SOFA score in the experimental groupwere significantly lower than those in the control group,and the levels of CD3^(+),CD4^(+),NK in the experimental group were significantly higher than those in the control group,the differences were statistically significant(all P<0.05).The mechanical ventilation time and days of hospitalization in experimental group[(7.38±0.71),(12.68±2.08)d]were significantly lower than those in control group[(9.68±1.41),(18.91±2.63)d];the differences were statistically significant(t=9.283,11.782,all P<0.05).The 28-day mortality of experimental group(7.32%)was significantly lower than that of control group(23.08%);the difference was statistically significant(χ^(2)=3.894,P=0.048).The total incidence of complications in experimental and control groups was 9.76%and 17.95%,respectively,and there was no significant difference(χ^(2)=1.131,P=0.288).Conclusion Therapeutic effect of meropenem in patients with septic shock was significant,which might be related to the effective improvement of H-FABP,I-FABP and Gal-3 levels.
作者
尹小君
李大欢
张冲
付玉梅
潘萌
YIN Xiaojun;LI Dahuan;ZHANG Chong;FU Yumei;PAN Meng(Department of Emergency Medicine,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang,Henan 471000,China)
出处
《热带医学杂志》
CAS
2023年第9期1261-1265,共5页
Journal of Tropical Medicine
基金
河南省医学科技攻关计划(201503156)
作者简介
尹小君(1985-),女,硕士研究生,主治医师,E-mail:jun20050101@163.com
