聶紹良 肖振濤 曾蕾莉 羅靖

摘 要：目的 研究血必凈注射液對(duì)重癥蝮蛇咬傷患者對(duì)機(jī)體免疫調(diào)節(jié)功能的影響。方法 對(duì)2014年7月～2017年10月本院急診科收治的重癥蝮蛇咬傷患者46例，常規(guī)治療組按照經(jīng)典的毒蛇治療法，觀察組使用血必凈注射液治療；健康對(duì)照組選擇為同期體檢正常人。分析各組在治療前、治療第1天、第3天及第7天，檢測(cè)其血清促炎介質(zhì)IL-6和抗炎介質(zhì)IL-10水平，代表性評(píng)估患者的免疫功能。結(jié)果 治療前和治療第1天，2個(gè)治療組IL-6無(wú)明顯區(qū)別，但均高于對(duì)照組，兩治療組于治療第3天、第7天IL-6水平均降低，差異有統(tǒng)計(jì)學(xué)意義（P<0.05），但觀察組較常規(guī)治療組下降（P<0，05）；各組IL-10水平在治療前與治療第1天，差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05），但第3天、第7天，治療組則高于健康對(duì)照組（P<0.05），兩治療組間，差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）。結(jié)論 重癥蝮蛇咬傷患者的免疫功能可出現(xiàn)紊亂，表現(xiàn)為早期促炎介質(zhì)占優(yōu)勢(shì)，后期抗炎介質(zhì)升高明顯，血必凈注射液可下調(diào)促炎介質(zhì)（IL-6）水平，在一定程度上調(diào)節(jié)機(jī)體免疫功能。

關(guān)鍵詞： 蛇咬傷；血必凈注射液；免疫功能；細(xì)胞因子

中圖分類號(hào)：R595.8 文獻(xiàn)標(biāo)識(shí)碼：A DOI：10.3969/j.issn.1006-1959.2018.15.039

文章編號(hào)：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.