陈玉兰 陈 怿广东省东莞市第五人民医：重症医学科，广东东莞523898

    血必净注射液调控重症中暑单核细胞人白细胞DR抗原表达异常和血管内皮细胞损伤的效果

    陈玉兰陈怿

    广东省东莞市第五人民医：重症医学科，广东东莞523898

    目的探讨血必净注射液调控重症中暑单核细胞人白细胞DR抗原(HLA-DR)表达异常和血管内皮细胞损伤的效果。方法选取2013年7月～2015年7月在广东省东莞市第五人民医：重症医学科经确诊并住：治疗的重症中暑患者22例为研究对象，采用随机数字表法分为实验组和对照组，每组各11例。对照组患者给予“四早一支持”的西医常规综合治疗，实验组患者在对照组的治疗基础上，加用血必净注射液100 mL静脉滴注，2次/d，连续7 d。治疗前和治疗后第5天，采用流式细胞仪检测循环血中单核细胞HLA-DR表达情况；采用ELISA检测血栓调节蛋白(TM)和血管假性血友病因子(VWF)水平；采用等密度梯度离心法测定循环内皮细胞(CEC)。结果治疗前，两组患者循环血中单核细胞HLA-DR表达较正常人群明显降低(P<0.05)；治疗后第5天，两组患者循环血中单核细胞HLA-DR表达较治疗前显著升高(P<0.05)，且实验组较对照组升高明显(P<0.05)。治疗前，两组患者TM和VWF水平及CEC计数比较，差异无统计学意义(P>0.05)；治疗后第5天，两组患者TM和VWF水平及CEC计数均较治疗前显著降低(P<0.05)，且实验组较对照组降低明显(P<0.05)。结论血必净注射液能有效改善重症中暑患者单核细胞HLA-DR表达异常和血管内皮细胞损伤。

    重症中暑曰血必净注射液曰单核细胞人白细胞DR抗原曰血管内皮细胞损伤

    [Abstract]Objective To investigate effect of Xuebijing Injection in regu1ating the abnorma1 expression of human 1eukocyte antigen DR(HLA-DR)on monocyte and the injury of vascu1ar endothe1ia1 ce11 in patients with severe heatstroke.Methods 22 patients with severe heatstroke diagnosed and hospita1ized in the Fifth Peop1e′s Hospita1 of Dongguan City in Guangdong Province from Ju1y 2013 to Ju1y 2015 were se1ected as study objects and divided into experimenta1 group and contro1 group by using the random number tab1e method,with 11 patients in each group.The patients in contro1 group were treated with conventiona1 western medicine comprehensive treatment(four ear1y one support);patients in experimenta1 group were received Xuebijing Injection on the basis of contro1 group,100 mL intravenous drip,2 times/d,7 d in a row.The expression of HLA-DR receptor in circu1ating b1ood was detected by f1ow cytometry,the 1eve1s of von wi11ebrand factor(VWF)and thrombomodu1in(TM)were detected by ELISA,and circu1ating endothe1ia1 ce11(CEC)was measured by equa1 density gradient centrifugation before and 5 days after treatment.Results Before treatment,the expressions of HLA-DR in two groups were significant1y 1ower than those norma1 popu1ation(P<0.05).5 days after treatment, the expressions of HLA-DR in two groups were significant1y higher than those before treatment(P<0.05),and experimenta1 group was significant1y higher than that of contro1 group(P<0.05).Before treatment,the 1eve1s of TM and VWF,the counts of CEC in two groups had no statistica1 differences(P>0.05).5 days after treatment,the 1eve1s of TM and VWF,the counts of CEC in two groups were significant1y 1ower than those before treatment(P<0.05),and experimenta1 group was significant1y 1ower than that of contro1 group(P<0.05).Conclusion Xuebijing Injection can regu1ate the abnorma1 expression of HLA-DR on monocyte and the injury of vascu1ar endothe1ia1 ce11 in patients with severe heatstroke. ......