中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (53): 9949-9952.doi: 10.3969/j.issn.1673-8225.2011.53.017

• 肾移植 kidney transplantation • 上一篇    下一篇

黄芪与血必净注射液在肾移植后肺部感染中的联合应用

聂  峰,孙煦勇,李壮江,谭  庆,赖彦华,董建辉,黄  莹,吴基华,曹  嵩,马茜华,李美思   

  1. 解放军第303医院器官移植中心,解放军广州军区肝肾移植中心,广西壮族自治区南宁市  530021
  • 收稿日期:2011-08-03 修回日期:2011-09-20 出版日期:2011-12-31 发布日期:2011-12-31
  • 通讯作者: 李壮江,主管护师,解放军第303医院器官移植中心,解放军广州军区肝肾移植中心,广西壮族自治区南宁市 530021
  • 作者简介:聂峰★,男,1975年生,湖南省东安县人,汉族,2005年解放军第一军医大学毕业,硕士,主治医师,主要从事肾移植临床工作。 dajjnf@sina.com

Combination of astragalus and Xuebijing injections for pulmonary infection after renal transplantation

Nie Feng, Sun Xu-yong, Li Zhuang-jiang, Tan Qing, Lai Yan-hua, Dong Jian-hui, Huang Ying, Wu Ji-hua, Cao Song, Ma Qian-hua, Li Mei-si   

  1. Organ Transplantation Center, the 303 Hospital of Chinese PLA, Liver and Renal Transplantation Center of PLA Guangzhou Military Area Command, Nanning  530021, Guangxi Zhuang Autonomous Region, China
  • Received:2011-08-03 Revised:2011-09-20 Online:2011-12-31 Published:2011-12-31
  • Contact: Li Zhuang-jiang, Nurse-in-charge, Organ Transplantation Center, the 303 Hospital of Chinese PLA, Liver and Renal Transplantation Center of PLA Guangzhou Military Area Command, Nanning 530021, Guangxi Zhuang Autonomous Region, China
  • About author:Nie Feng★, Master, Attending physician, Organ Transplantation Center, the 303 Hospital of Chinese PLA, Liver and Renal Transplantation Center of PLA Guangzhou Military Area Command, Nanning 530021, Guangxi Zhuang Autonomous Region, China dajjnf@sina.com

摘要:

背景:许多实验和临床研究证实黄芪注射液及血必净注射液可增强机体免疫力、阻断体内炎症反应,但尚未见到应用于移植后感染的报道。
目的:观察联合应用黄芪注射液及血必净注射液治疗肾移植后肺部感染的效果。
方法:入选肾移植后1年内发生肺部感染,停用免疫抑制剂并抗感染治疗5 d后症状加重或无好转患者28例,随机分为治疗组与对照组各14例进行常规治疗基础上的免疫支持治疗。常规治疗包括调整免疫抑制剂、经验性抗感染、根据药敏结果选择抗感染药物以及排痰、降温、纠正内环境失衡等对症处理。重症感染患者选用乌司他丁等保护机体各器官功能及呼吸机辅助呼吸等治疗。免疫支持疗法:治疗组予黄芪注射液、血必净注射液,对照组予人免疫球蛋白静脉滴注。
结果与结论:治疗组患者应用免疫支持药物后7 d后CD3+CD4+、CD3+CD8+T淋巴细胞较用药前明显上升,治疗组的好转率、入院到感染好转时间、平均住院日、死亡率、急性排斥反应发生率与对照组比较,差异无显著性意义(P > 0.05)。结果显示在积极的常规治疗基础上给予黄芪及血必净注射液联合治疗可促使CD3+CD4+CD8+回升,使得过度抑制的免疫功能得到不同程度恢复,缩短免疫功能调节和炎症反应过渡时间,改善预后,获得与人免疫球蛋白相似的疗效,同时未发现明显毒副作用。

关键词: 黄芪注射液, 血必净注射液, 肾移植, 肺部感染, 人免疫球蛋白

Abstract:

BACKGROUND: Many experiments and clinical studies confirmed that astragalus and Xuebijing injections can strengthen body immunity and block inflammatory response in vivo, but there are no reporters on application of astragalus and Xuebijing injections for the infection after transplantation.
OBJECTIVE: To observe the joint application effect of astragalus and Xuebijing injections on pulmonary infection after renal transplantation.
METHODS: Totally 28 cases who suffered pulmonary infection within one year after renal transplantation and had no obvious improvement in clinical symptoms and imaging examination at 5 days after stop using immunosuppressant and received anti-infective treatment. These cases were divided randomly into two groups (14 for each), treatment group and control group, to receive immunization support therapy based on the conventional therapy. Conventional therapy included immunosuppressant adjustment, empirical anti-infection, selection of anti-infective agents according to drug sensitive result and other symptomatic treatments like sputum excretion, temperature reduction, and adjustment internal environment. For patients who suffered severe infection, ulinastatin and breathing machine were used to protect the functions of each organ and assist breathing. Immunization support included: astragalus injection and Xuebijing injection for the treatment group; human normal immunoglobulin for the control group by intravenous drip.
RESULTS AND CONCLUSION: Compared with the number of lymph cells of CD3+CD4+ and CD3+CD8+ from the patients with treatment group before taking immunization support drugs, the lymph cells thereof obviously increased after 7 days. There was no significant difference in the improvement rate, the period from the time of admission to the time of getting better after infection, the average length of stay, the mortality rate and the incidence of acute rejection between the treatment group and the control group (P > 0.05). Jointly applying the astragalus and Xuebijing injections on the basis of the positive conventional therapy can promote the increase of CD3+CD4+CD8+, restore the overly inhibitory immunologic function at different levels and shorten the disorganization time adjusted by immunologic function to sustain the balance of immune inflammation regulatory function, improve prognosis, obtain the similar therapeutic effect of human normal immunoglobulin, and at the same time, the toxic side effect is small.

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