發(fā)布時間：2018-08-27 09:56

【摘要】：目的分析辛伐他汀對膿毒癥患者外周血單核細(xì)胞(PBMCs)Toll樣受體4(TLR4)及基質(zhì)金屬蛋白酶9(MMP-9)的影響,探討其臨床應(yīng)用價值。方法選取本院2014年10月至2015年10月收治的180例膿毒癥患者,隨機分為觀察組、對照組,各90例,均實施膿毒癥常規(guī)綜合治療,觀察組加用辛伐他汀口服,1次/d,每次40 mg,持續(xù)15 d。比較兩組患者治療前后PBMCs TLR4、MMP-9表達(dá)情況、血清炎性因子水平變化及病死率。結(jié)果兩組患者治療后TLR4均顯著降低,觀察組降低更為明顯;治療1 d后,兩組患者MMP-9均有所上升,而后逐漸下降,觀察組下降更為明顯,差異有統(tǒng)計學(xué)意義(P0.05)。兩組患者治療后TNF-α、IL-1β、IL-6均顯著下降,IL-10均顯著上升,觀察組變化更為明顯,差異有統(tǒng)計學(xué)意義(P0.05)。觀察組治療4周后病死率為20.00%,略低于對照組的26.67%,但差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論辛伐他汀能夠顯著降低膿毒癥患者PBMCs TLR4、MMP-9表達(dá),延緩患者炎癥反應(yīng)進程,值得進一步推廣研究。
[Abstract]:Objective to investigate the effect of simvastatin on (PBMCs) Toll like receptor 4 (TLR4) and matrix metalloproteinase 9 (MMP-9) in peripheral blood monocytes of patients with sepsis. Methods 180 patients with sepsis admitted in our hospital from October 2014 to October 2015 were randomly divided into observation group (n = 90) and control group (n = 90). All patients were treated with conventional comprehensive therapy of sepsis. The observation group was treated with simvastatin once a day for 15 mg,. The expression of PBMCs TLR4,MMP-9, the changes of serum inflammatory factors and the fatality rate before and after treatment were compared between the two groups. Results the TLR4 of the two groups decreased significantly after treatment, especially in the observation group. After 1 day of treatment, the MMP-9 of the two groups increased, but gradually decreased, and the decrease of the observation group was more obvious (P0.05). After treatment, TNF- 偽 IL-1 尾 and IL-6 were significantly decreased and IL-10 was significantly increased in the two groups, especially in the observation group, the difference was statistically significant (P0.05). The mortality of the observation group after 4 weeks treatment was 20.00 slightly lower than that of the control group 26.67 but the difference was not statistically significant (P0.05). Conclusion Simvastatin can significantly reduce the expression of PBMCs TLR4,MMP-9 and delay the progress of inflammatory reaction in sepsis patients.
【作者單位】： 長治市人民醫(yī)院;北京大學(xué)第一醫(yī)院;
【基金】：國家自然科學(xué)基金,基金號:30870865
【分類號】：R459.7

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