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目的研究小剂量肝素对重症脓毒症患者外周血炎性因子及细胞黏附分子的影响。方法脓毒症患者50例,随机分成对照组(n=25),肝素组(n=25)。治疗前及治疗后24 h、72 h、120 h分别采外周血检测TNF-α、IL-1β、VCAM-1、c ICAM-1的水平。结果治疗前,两组患者外周血的上述指标水平差异无统计学意义(P>0.05)。与对照组比较,治疗后24 h、72 h、120 h,肝素组外周血TNF-α、IL-1β、VCAM-1、c ICAM-1水平、APACHEⅡ评分下降,差异有统计学意义(P<0.05);与24 h比较,72 h、120 h组的细胞因子水平降低,差异有统计学意义(P<0.05),而120 h与72 h上述指标水平差异无统计学意义(P>0.05)。结论肝素能减轻脓毒症患者的炎性反应,抑制细胞黏附。
Objective To study the effects of low dose heparin on inflammatory cytokines and cell adhesion molecules in peripheral blood of patients with severe sepsis. Methods Fifty patients with sepsis were randomly divided into control group (n = 25) and heparin group (n = 25). The levels of TNF-α, IL-1β, VCAM-1 and c ICAM-1 in peripheral blood were detected before treatment and 24 h, 72 h and 120 h after treatment. Results Before treatment, there was no significant difference in the above indexes between the two groups (P> 0.05). Compared with the control group, the levels of TNF-α, IL-1β, VCAM-1, c ICAM-1 and APACHEⅡin the peripheral blood of heparin group decreased 24 h, 72 h and 120 h after treatment, the difference was statistically significant (P < 0.05). Compared with 24 h, the levels of cytokines decreased at 72 h and 120 h (P <0.05), while there was no significant difference between 120 h and 72 h (P> 0.05) . Conclusion Heparin can reduce inflammatory reaction and inhibit cell adhesion in sepsis patients.