Effect of ulinastatin on early inflammatory and T lymphocyte immune responses in patients with severe multiple trauma and its clinical value

Han LIU; Xiangyu CHEN; Song HUANG; Yuansong ZHANG; Wenjun DENG; Minghua LIU

doi:10.16016/j.1000-5404.201906077

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Effect of ulinastatin on early inflammatory and T lymphocyte immune responses in patients with severe multiple trauma and its clinical value

Clinical Medicine | 更新时间：2026-01-09

- Effect of ulinastatin on early inflammatory and T lymphocyte immune responses in patients with severe multiple trauma and its clinical value
- Journal of Third Military Medical University Vol. 41, Issue 17, Pages: 1666-1671(2019)
- 作者机构：
  
  400038 重庆，陆军军医大学(第三军医大学)第一附属医院急救部
- 作者简介：
- 基金信息：
  
  the Special Project of Social Undertaking Science and Technology Innovation of Chongqing(CSTC2016SHMSZX130007)
- DOI：10.16016/j.1000-5404.201906077
  CLC： R642.05;R969.4;R977.6
- Received：08 June 2019，
  
  Revised：2019-07-09，
  
  Published：15 September 2019
- 稿件说明：
移动端阅览
Han LIU, Xiangyu CHEN, Song HUANG, et al. Effect of ulinastatin on early inflammatory and T lymphocyte immune responses in patients with severe multiple trauma and its clinical value[J]. Journal of Third Military Medical University, 2019, 41(17): 1666-1671.
DOI：

Han LIU, Xiangyu CHEN, Song HUANG, et al. Effect of ulinastatin on early inflammatory and T lymphocyte immune responses in patients with severe multiple trauma and its clinical value[J]. Journal of Third Military Medical University, 2019, 41(17): 1666-1671. DOI： 10.16016/j.1000-5404.201906077.

摘要

目的

探讨乌司他丁在严重多发伤患者早期炎症及T淋巴细胞免疫中的作用，并分析其临床价值。

方法

选取我科2016年1月至2019年1月收治的严重多发伤患者40例，采用随机数字表法分为对照组和乌司他丁治疗组(

=20)。对照组患者给予常规治疗；乌司他丁治疗组患者在其基础上，入院当天即开始连续7 d静脉滴注乌司他丁(100 kU、3次/d)，分别比较两组患者治疗前及治疗后第1、3、7天外周血T淋巴细胞亚群变化，以及肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)、皮质醇及各临床相关指标的差异。

结果

与对照组患者比较，在治疗后第1、3、7天，乌司他丁治疗组患者CD3

、CD4

/CD8

明显升高(

0.05)，TNF-α、IL-6及皮质醇水平显著降低(

0.05)，两组患者谷丙转氨酶(ALT)、尿素氮(BUN)、肌酐(Scr)值差异不明显；两组患者平均住院时间、入住ICU时间、并发症发生率间差异均有统计学意义(

0.05)，但病死率差异无统计学意义。

结论

乌司他丁应用于严重多发伤后早期，能促进T淋巴细胞亚群的恢复，减少炎症细胞因子的释放，抑制炎症反应，减少ICU入住和平均住院时间，降低并发症发生率，但不能改善病死率。

Abstract

Objective

To investigate the roles of ulinastatin in early inflammatory and T lymphocyte immune responses in patients with severe multiple trauma and analyze its clinical value.

Methods

Forty patients with severe multiple-trauma admitted in our center from January 2016 to January 2019 were enrolled in this study

and randomly divided into ulinastatin group (

=20) and control group (

=20). The patients of the control group were given conventional treatment

and those of the ulinastatin group were given an intravenous infusion of ulinastatin

100 kU

3 times per day

from the day of admission for 7 consecutive days besides conventional treatment. The counts of T lymphocyte subsets (CD3

and CD4

)

ratio of CD4

/CD8

levels of inflammatory factors (TNF-α and IL-6) and cortisol

and other clinical relevant indexes were measured and compared before treatment

on days 1

3 and 7 after treatment

respectively.

Results

The counts of CD3

and CD4

lymphocytes and the ratio of CD4

/CD8

were significantly higher in the ulinastatin group than the control group on days 1

3 and 7 after treatment (

0.05)

while the serum levels of TNF-α

IL-6 and cortisol were obviously lower (

0.05). There were no notable differences in the levels of alpha-alanine aminotransferase (ALT)

urea nitrogen (BUN) and creatinine (Scr) between the 2 groups. But significant differences were seen in the average length of hospital stay

length of ICU stay and incidence of complications between them (

0.05)

though no difference in mortality.

Conclusion

Ulinastatin can promote the recovery of T lymphocyte subsets

decrease the release of inflammatory cytokines and reduce the inflammatory response in early after severe multiple injuries

and thus can reduce the lengths of ICU stay and hospital stay and incidence of complications

but it has no effect on mortality.

关键词

Keywords

references

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