Effects of ulinastatin combined with meropenem on immune function, interleukin and TNF-levels in elderly patients with severe infection / 中国基层医药

ABSTRACT

Objective:To investigate the effects of ulinastatin combined with meropenem on immune function, interleukin 2(IL-2), interleukin 4(IL-4), interleukin-6(IL-6), interleukin 10(IL-10) and tumor necrosis factor (TNF-) levels in elderly patients with severe infection.Methods:From January 2016 to June 2018, 60 elderly patients with severe infections admitted to the Second People's Hospital of Lishui were randomly divided into control group(30 cases) and observation group(30 cases). The patients in the control group were treated with meropenem, while the patients in the observation group were treated with ulinastatin on the basis of the control group.Both two groups were treated for 14 days.The therapeutic effects, changes of T lymphocyte subsets, IL-2, IL-4, IL-6, IL-10 and TNF-levels, recovery time of gastrointestinal function and occurrence of systemic inflammatory response syndrome(SIRS) before and after treatment were compared between the two groups.Results:The total effective rate of the observation group(93.33%) was higher than that of the control group(66.67%)(χ 2=6.667, P<0.05). After treatment, CD 3+ [(64.38±3.19)%], CD 4+ [(40.39±2.35)%]and CD 4+/CD 8+ (1.65±0.19) in the observation group were higher than those in the control group[(58.94±3.56)%, (35.47±2.87)% and (1.34±0.14)]( t=6.233, 7.265, 3.834, all P<0.05). The serum levels of IL-2[(126.87±17.49)ng/L], IL-4[(8.98±2.14)g/L], IL-6[(176.89±23.1)ng/L], IL-10[(37.94±12.56)ng/L] and TNF-α[(163.45±17.96)ng/L]in the observation group were lower than those in the control group[(343.27±28.56)ng/L, (19.65±4.56) g/L, (346.37±38.98)ng/L, (83.21±18.56)ng/L and (254.37±23.45)ng/L]( t=35.392, 10.602, 20.476, 11.064, 16.860, all P<0.05). The recovery time of gastrointestinal function in the observation group[(5.31±1.29)d] was shorter than that in the control group[(6.97±1.43)d]( t=4.721, P<0.05), while the incidence of SIRS(13.33%) was lower than that in the control group(43.33%)(χ 2=6.648, P<0.05). Conclusion:Ulinastatin combined with meropenem is effective in the treatment of elderly patients with severe infection.It can improve the immune function of the patients, reduce the levels of IL-2, IL-4, IL-6, IL-10 and TNF-, and alleviate the inflammatory reaction.It is worthy of clinical reference.