|本期目录/Table of Contents|

[1]赵扬,徐洋,谢继,等.去甲肾上腺素和垂体后叶素对脓毒症休克患者细胞因子的影响[J].医学研究与战创伤救治(原医学研究生学报),2016,18(02):119-121,134.[doi:10.3969/j.issn.1672-271X.2016.02.003]
　ZHAO Yang,XU Yang,XIE Ji,et al.Effect of norepinephrine and vasopressin on cytokine level of septic shock patients[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2016,18(02):119-121,134.[doi:10.3969/j.issn.1672-271X.2016.02.003]
点击复制

去甲肾上腺素和垂体后叶素对脓毒症休克患者细胞因子的影响()
分享到62.8K

《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第18卷
期数:
2016年02期
页码:
119-121,134
栏目:
出版日期:
2016-04-09

文章信息/Info

Title:
Effect of norepinephrine and vasopressin on cytokine level of septic shock patients
作者:
赵扬; 徐洋; 谢继; 杨志洲; 孙兆瑞; 聂时南
210002 江苏南京，南京军区南京总医院急救医学科
Author(s):
ZHAO Yang;  XU Yang;  XIE Ji;  YANG Zhi-zhou;  SUN Zhao-rui;  NIE Shi-nan.
Department of Emergency Medicine， Nanjing General Hospital of Nanjing Military Command ，PLA, Nanjing, Jiangsu 210002， China
关键词:
去甲肾上腺素; 垂体后叶素; 脓毒症休克; 细胞因子; 病死率
Keywords:
norepinephrine;  vasopressin;  septic shock;  cytokine;  mortality
分类号:
R631
DOI:
10.3969/j.issn.1672-271X.2016.02.003
文献标志码:
A
摘要:
目的 探讨去甲肾上腺素和垂体后叶素对脓毒症休克患者细胞因子水平的影响，为临床使用去甲肾上腺素及垂体后叶素提供理论依据。方法 回顾性分析2012年1月- 2014年12月入住某院急诊重症监护病房的脓毒症休克患者病历资料，按照血管活性药（去甲肾上腺素和垂体后叶素）使用情况将入选患者分为对照组（未使用血管活性药物）、去 甲肾上腺素组和垂体后叶素组，比较两组患者急性生理学与慢性健康评分Ⅱ(APACHEⅡ)、细胞因子肿瘤坏死因子α（TNF-α）、白细胞介素1（IL-1）、白细胞介素6（IL-6）水平 及28 d病死率。结果 三组患者入院时APACHEⅡ评分差异无统计学意义；和对照组相比，去甲肾上腺素和垂体后叶素均能降低脓毒症患者早期细胞因子浓度，去甲肾上腺素降低脓毒 症休克患者细胞因子水平的作用比垂体后叶素更明显；三组患者的28 d病死率差异无统计学意义。结论 去甲肾上腺素和垂体后叶素能降低脓毒症休克患者早期细胞因子水平，但对 28 d病死率无影响。
Abstract:
Objective To investigate the effect of norepinephrine and vasopressin on cytokine level of septic shock patients, so as to provide rational consultation for clinical using of norepinephrine and vasopressin. Methods We performed a retrospective analysis for medical records of septic shock patients who admitted to our emergency intensive care unit from January 2012 to December 2014. According to the usage of vasoactive drugs (noradrenaline and vasopressin), patients were divided into control group (no vasoactive drugs), norepinephrine group and vasopressin group. We compared the acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), cytokine level and 28-day mortality of the three groups. Results There were no difference between the three groups of hospitalized APACHEⅡ score; Compared with the control group, norepinephrine and vasopressin could decrease early cytokine concentration of septic shock patients; Compared with the vasopressin group, norepinephrine reduced cytokine level in septic shock patients more obvious than vasopressin. There were no significant difference in 28-day mortality of the three group patients. Conclusion Norepinephrine and vasopressin can reduce early cytokine level of septic shock patients, but not reduce 28-day mortality.

参考文献/References:

[1]Fjell CD, Simone T, Hsu JL, et al. Cytokines and signaling molecules predict clinical outcomes in sepsis[J]. PLoS One, 2013, 8(11): e79207-e79207.
[2]Tom VDP, Lowry SF. Tumor necrosis factor in sepsis: mediator of multiple organ failure or essential part of host defense? [J]. Shock, 1995, 3(1): 1-12.
[3]Dellinger RP, Levy MM, Rhodes A, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012[J]. Intensive Care Med, 2013, 39(2): 165-228.
[4]郭春文，闫 红，黄阿勤.无创超声心输出量监测在休克早期复苏中的指导作用[J].东南国防医药，2015，17（3）：263-265.
[5]Dombrovskiy VY, Martin AA, Jagadeeshan S, et al. Rapid increase in hospitalization and mortality rates for severe sepsis in the United States: A trend analysis from 1993 to 2003[J]. Crit Care Med, 2007, 35(5): 1244-1250.
[6]Pottier LL, Sapir T, Bendaoud B, et al. Intravenous immunoglobulin and cytokines[J]. Ann N Y Acad Sci, 2007, 1110(1): 426-432.
[7]Geneviève F, Irène DS, Pierre T, et al. Innate immune functions of immature neutrophils in patients with sepsis and severe systemic inflammatory response syndrome[J]. Crit Care Med, 2013, 41(3): 820-832.
[8]Lowes DA, Webster NR, Murphy MP, et al. Antioxidants that protect mitochondria reduce interleukin-6 and oxidative stress, improve mitochondrial function, and reduce biochemical markers of organ dysfunction in a rat model of acute sepsis[J]. Br J Anaesth, 2013, 110(3): 472-480.
[9]Kurt AN, Aygun AD, Godekmerdan A, et al. Serum IL-1beta, IL-6, IL-8, and TNF-alpha levels in early diagnosis and management of neonatal sepsis[J]. Mediators Inflamm, 2007, 2007(1): 168-172.
[10]Kumar A, Thota V, Dee L, et al. Tumor necrosis factor alpha and interleukin 1beta are responsible for in vitro myocardial cell depression induced by human septic shock serum[J]. J Exp Med, 1996, 183(3): 166.
[11]Hinder F, Stubbe HD, Van AH, et al. Role of nitric oxide in sepsis-associated pulmonary edema[J]. Am J Respir Crit Care Med, 1999, 159(1): 252-257.
[12]Wolkow PP. Involvement and dual effects of nitric oxide in septic shock[J]. Inflamm Res, 1998, 47(4): 152-166.
[13]Baghel K, Srivastava RN, Chandra A, et al. TNF-α, IL-6, and IL-8 cytokines and their association with TNF-α-308 G/A polymorphism and postoperative sepsis[J]. J Gastrointest Surg, 2014, 18(8): 1486-1494.
[14]Lixia Z, Brinton RD. Suppression of proinflammatory cytokines interleukin-1beta and tumor necrosis factor-alpha in astrocytes by a V1 vasopressin receptor agonist: a cAMP response element-binding protein-dependent mechanism[J]. J Neurosci, 2004, 24(9): 2226-2235.
[15]Boyd JH, Holmes CL, Wang Y, et al. Vasopressin decreases sepsis-induced pulmonary inflammation through the V2R[J]. Resuscitation, 2008, 79(2): 325-331.
[16]Chassin C, Hornef MW, Lotz M, et al. Hormonal control of the renal immune response and antibacterial host defense by arginine vasopressin[J]. J Exp Med, 2007, 204(12): 2837-2852.
[17]McNamee EN, Griffin EW, Ryan KM, et al. Noradrenaline acting at β-adrenoceptors induces expression of IL-1β and its negative regulators IL-1ra and IL- 1RII, and drives an overall anti-inflammatory phenotype in rat cortex[J]. Neuropharmacology, 2010, 59(1-2): 37-48.
[18]Mcnamee EN, Ryan KM, Re GER, et al. Noradrenaline acting at central beta-adrenoceptors induces interleukin-10 and suppressor of cytokine signaling-3 expression in rat brain: implications for neurodegeneration[J]. Brain Behav Immun, 2010, 24(4): 660-671.
[19]Briest W, Rassler B, Deten A, et al. Norepinephrine-induced interleukin-6 increase in rat hearts: differential signal transduction in myocytes and non- myocytes[J]. Pflugers Arch, 2003, 446(4): 437-446.
[20]Torres KCL, Teixeira MM, Gollob KJ, et al. Norepinephrine, dopamine and dexamethasone modulate discrete leukocyte subpopulations and cytokine profiles from human PBMC[J]. J Neuroimmunol, 2005, 166(1-2): 144-157.
[21]Feldman ED, Weinreich DM, Carroll NM, et al. Interferon gamma-inducible protein 10 selectively inhibits proliferation and induces apoptosis in endothelial cells[J]. Ann Surg Oncol, 2006, 13(1): 125-133.
[22]Campanella GS, Colvin RA, Luster AD. CXCL10 can inhibit endothelial cell proliferation independently of CXCR3[J]. PLoS One, 2010, 5(9): e12700.
[23]Aird WC. The role of the endothelium in severe sepsis and multiple organ dysfunction syndrome[J]. Blood, 2003, 101(10): 3765-3777.

相似文献/References:

[1]邓云,张春华,丁惠.垂体后叶素在腹腔镜下卵巢囊肿剥除术中的应用研究[J].医学研究与战创伤救治(原医学研究生学报),2014,16(05):493.[doi:10.3969/j.issn.1672-271X.2014.05.015]
　DENG Yun,ZHANG Chun-hua,DING Hui..Clinical analysis of vasopressin injection technique in laparoscopic ovarian cystectomy[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2014,16(02):493.[doi:10.3969/j.issn.1672-271X.2014.05.015]
[2]戴凤英,曾清芳,洪丽君.腹腔镜下囊肿剥除联合垂体后叶素治疗卵巢子宫内膜异位囊肿的临床分析[J].医学研究与战创伤救治(原医学研究生学报),2015,17(06):645.[doi:10.3969/j.issn.1672-271X.2015.06.026]
[3]宁征远,谢姗姗,李健,等.阿戈美拉汀联合坦度螺酮对老年抑郁症患者血清NE、5-HT水平的影响[J].医学研究与战创伤救治(原医学研究生学报),2017,19(03):251.[doi:10.3969/j.issn.1672-271X.2017.03.007]
　NING Zheng-yuan,XIE Shan-shan,LI Jian,et al.The effect of agomelatine combined with tandospirone on the expression of NE，5-HT in the elder patients with depression[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2017,19(02):251.[doi:10.3969/j.issn.1672-271X.2017.03.007]

备注/Memo

备注/Memo:
全军后勤面上项目（CNJ14L002）；国家自然科学基金课题（81401583）；南京军区重点课题（12732）；南京军区面上项目（14MS111）
更新日期/Last Update: 2016-03-20