匹多莫德对重度烧伤患者免疫调理的临床观察.docVIP

匹多莫德对重度烧伤患者免疫调理的临床观察 　　【摘要】 目的：探讨匹多莫德对重度烧伤患者免疫调理的作用。方法：将入选重度烧伤患者30例，随机数字表法分为对照组和治疗组，治疗组应用匹多莫德0.8 g，2次/d，连续服用21 d；对照组未使用匹多莫德，在烧伤后1、7、14、21 d采集外周静脉血，检测各组患者淋巴细胞数目，流式细胞仪检测CD4+、CD8+T细胞的数量及其凋亡率，获得CD4+/CD8+值。观察两组临床愈合时间。结果：1 d两组淋巴细胞数目、CD4+和CD8+的数量及其凋亡率、CD4+/CD8+值比较，差异无统计学意义；7 d、14 d、21 d时，治疗组淋巴细胞数目、CD4+、CD4+/CD8+均高于对照组，CD4+、CD8+细胞凋亡率明显下降，比较差异有统计学意义（P0.05）；治疗组临床愈合时间较对照组短，但差异无统计学意义。结论：匹多莫德在重度烧伤患者的治疗中是一种较好的免疫调节剂。 　　【关键词】 重度烧伤； 淋巴细胞； 免疫； 凋亡 　　【Abstract】 Objective： To observe the changes of lymphocyte in severe burn patients with the treatment of Pidotimod. Method： 30 severe burn patients were randomly divided into two groups. The observer group was treated with Pidotimod. The control group was treated without Pidotimod. The peripheral venous blood samples of the patients were collected on days 1， 7， 14， and 21 after the burn. The number of the lymphocyte was observed. CD4+， CD8+ lymphocyte and its apoptosis rate were detected by flow cytometry. The durations of the cure of the patients were observed. Result： There were no significant differences between the two groups on the lymphocyte， and the number of CD4+， CD8+ and its apoptosis rate on the 1 day after the burn. But the number of lymphocyte， CD4+， CD8+， and CD4+/CD8+ ratio of the observer group was significant higher than that of the control group （P0.05） on 7， 14， 21 days after burn. At the same time the apoptosis rate of CD4+， CD8+ lymphocyte was lower than that of the control group. The average cure time of the observer group was shorter than that of the control group， but there was no significant difference. Conclusion： The Pidotimod as the adjustment of immunological function may be helpful in the treatment of the severe burn patients. 　　【Key words】 Severe burn； Lymphocyte； Immunology； Apoptosis 　　First-author’s address： The 264th Hospital of the PLA， Taiyuan 030001， China 　　doi：10.3969/j.issn.1674-4985.2014.25.020 　　烧伤可导致机体免疫功能紊乱，严重的烧伤程度、过度的急性炎症反应会导致机体出现免疫抑制，这会使外周循环中淋巴细胞数目明显减少，即使存活淋巴细胞大部分也处于克隆无反应状态，甚至凋亡[1]。