血必净注射液对重症蝮蛇咬伤患者免疫功能的影响

聂绍良 肖振涛 曾蕾莉 罗靖

摘 要：目的 研究血必凈注射液对重症蝮蛇咬伤患者对机体免疫调节功能的影响。方法 对2014年7月～2017年10月本院急诊科收治的重症蝮蛇咬伤患者46例，常规治疗组按照经典的毒蛇治疗法，观察组使用血必净注射液治疗；健康对照组选择为同期体检正常人。分析各组在治疗前、治疗第1天、第3天及第7天，检测其血清促炎介质IL-6和抗炎介质IL-10水平，代表性评估患者的免疫功能。结果 治疗前和治疗第1天，2个治疗组IL-6无明显区别，但均高于对照组，两治疗组于治疗第3天、第7天IL-6水平均降低，差异有统计学意义（P<0.05），但观察组较常规治疗组下降（P<0，05）；各组IL-10水平在治疗前与治疗第1天，差异无统计学意义（P>0.05），但第3天、第7天，治疗组则高于健康对照组（P<0.05），两治疗组间，差异无统计学意义（P>0.05）。结论 重症蝮蛇咬伤患者的免疫功能可出现紊乱，表现为早期促炎介质占优势，后期抗炎介质升高明显，血必净注射液可下调促炎介质（IL-6）水平，在一定程度上调节机体免疫功能。

关键词： 蛇咬伤；血必净注射液；免疫功能；细胞因子

中图分类号：R595.8 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.15.039

文章编号：1006-1959（2018）15-0123-03

Effect of Xuebijing Injection on Immune Function of Patients with Severe Agkistrodon Halys Bite

NIE Shao-liang，XIAO Zhen-tao，ZENG Lei-li，LUO Jing

（Department of Emergency，PLA No.169 Hospital，Hengyang 421002，Hunan，China）

Abstract：Objective To study the effect of Xuebijing injection on immune regulation in patients with severe Agkistrodon halys bite. Methods From July 2014 to October 2017，46 patients with severe Agkistrodon halys bite were treated in the emergency department of our hospital.The conventional treatment group was treated with classical snake venomous therapy，and the observation group was treated with Xuebijing injection.The normal person in the same period as healthy control group was selected.The levels of serum proinflammatory mediators IL-6 and anti-inflammatory mediators IL-10 were detected before treatment，the first day，the third day and the 7th day after treatment，and the immune function of the patients was evaluated.Results Before treatment and the first day of treatment，there was no significant difference in IL-6 between the two treatment groups，but both of them were higher than the control group.The average of IL-6 decreased on the third day and the seventh day in the two treatment group，the difference was statistically significant（P<0.05）.But the observation group was lower than the conventional treatment group（P<0，05）.There was no significant difference in IL-10 level between the two groups before and the first day（P>0.05），but on the third day and the seventh day，the treatment group was higher than the healthy control group（P<0.05），and there was no statistical difference between the two treatment groups（P>0.05）.Conclusion The immune function of the patients with severe Agkistrodon halys bite may appear disorder，which is characterized by the predominance of early inflammatory mediators，and the increase of anti-inflammatory mediators in the later stage. Xuebijing injection can down-regulate the level of IL-6 and regulate the immune function of the organism to a certain extent.