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
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[摘要] 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院重症医学科经确诊并住院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。
[关键词] 重症中暑；血必净注射液；单核细胞人白细胞DR抗原；血管内皮细胞损伤
[中图分类号] R135.3 [文献标识码] A [文章编号] 1673-7210（2016）04（a）-0011-04
Effect of Xuebijing Injection in regulating the abnormal expression of HLA-DR on monocyte and the injury of vascular endothelial cell in patients with severe heatstroke
CHEN Yulan CHEN Yi
Department of ICU， the Fifth People′s Hospital of Dongguan City， Guangdong Province， Dongguan 523898， China
[Abstract] Objective To investigate effect of Xuebijing Injection in regulating the abnormal expression of human leukocyte antigen DR （HLA-DR） on monocyte and the injury of vascular endothelial cell in patients with severe heatstroke. Methods 22 patients with severe heatstroke diagnosed and hospitalized in the Fifth People′s Hospital of Dongguan City in Guangdong Province from July 2013 to July 2015 were selected as study objects and divided into experimental group and control group by using the random number table method， with 11 patients in each group. The patients in control group were treated with conventional western medicine comprehensive treatment （four early one support）； patients in experimental group were received Xuebijing Injection on the basis of control group， 100 mL intravenous drip， 2 times/d， 7 d in a row. The expression of HLA-DR receptor in circulating blood was detected by flow cytometry， the levels of von willebrand factor （VWF） and thrombomodulin （TM） were detected by ELISA， and circulating endothelial cell （CEC） was measured by equal density gradient centrifugation before and 5 days after treatment. Results Before treatment， the expressions of HLA-DR in two groups were significantly lower than those normal population （P < 0.05）. 5 days after treatment， the expressions of HLA-DR in two groups were significantly higher than those before treatment （P < 0.05）， and experimental group was significantly higher than that of control group （P < 0.05）. Before treatment， the levels of TM and VWF， the counts of CEC in two groups had no statistical differences （P > 0.05）. 5 days after treatment， the levels of TM and VWF， the counts of CEC in two groups were significantly lower than those before treatment （P < 0.05）， and experimental group was significantly lower than that of control group （P < 0.05）. Conclusion Xuebijing Injection can regulate the abnormal expression of HLA-DR on monocyte and the injury of vascular endothelial cell in patients with severe heatstroke.
[Key words] Severe heatstroke； Xuebijing Injection； Monocyte HLA-DR； Vascular endothelial cell injury