塞来昔布对脓毒症的疗效及可能机制

    Effect of celecoxib in the treatment of sepsis and its possible mechanism

    • 摘要: 目的:观察塞来昔布对脓毒症的疗效,并探讨可能的作用机制。方法:选取2010年3月至2014年11月收治的脓毒症病人52例,随机分为观察组(塞来昔布组,28例)和对照组(常规治疗组,24例)。比较和分析入组病人的基线资料、疗效及预后相关指标和治疗前后的感染、炎症指标及T细胞亚群等指标。结果:观察组病人的总住院时间和治疗1周后的APACHE Ⅱ评分均明显低于对照组(P<0.01);治疗前2组病人的感染、炎症指标及T细胞亚群指标差异均无统计学意义(P>0.05),而治疗1周后,观察组病人的白细胞计数和降钙素原、C反应蛋白、肿瘤坏死因子-α、白介素-1β和白介素-6水平均显著低于对照组(P<0.01);另外,治疗1周后,观察组病人的CD4+、CD4+/CD8+均明显高于对照组,而CD8+则低于对照组(P<0.01)。结论:塞来昔布能够通过抑制机体炎症反应,改善T细胞免疫功能,显著改善脓毒症病人的预后。

       

      Abstract: Objective:To observe the curative effect of celecoxib in sepsis patients,and explore its possible mechanism.Methods:Fifty-two patients with sepsis were randomly divided into the observation group(28 cases treated with celecoxib) and control group(24 cases treated with traditional method) from March 2010 to November 2014.The data of the general information,the correlated indicators of efficacy and prognosis,and the indicators of infection,inflammation and T cell subsets before and after treatment between two groups were analyzed and compared.Results:The total length of hospital stay and APACHE Ⅱ score in observation group were lower than those in control group after 1 week of treatment(P<0.01).The differences of the indexes of infection,inflammation and T cell subsets before treatment between two groups were not statistically significant(P>0.05),but the levels of WBC,PCT,CRP,TNF-α,IL-1β and IL-6 in observation group were obviously lower than those in control group after 1 week of treatment(P<0.01).After 1 week of treatment,the levels of CD4+ and CD4+/CD8+ T cells in observation group were significantly higher than those in control group,and the level of CD8+ T cells in observation group was lower than that in control group(P<0.01).Conclusions:Celecoxib can significantly inhibit the inflammatory reaction,and improve the immunologic function of T lymphocytes and prognosis of patients with sepsis.

       

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