敗血症性ショック時の血清腫瘍壊死因子αおよびインターロイキン-6に対するリンゲルピルビン酸ナトリウム溶液の効果

Effects of Ringer's sodium pyruvate solution on serum tumor necrosis factor-α and interleukin-6 upon septic shock.

• Wei Dong
• Guannan Zhang
• Feng Qu

抄録

目的:

敗血症性ショック時の腫瘍壊死因子-α（ＴＮＦ-α）およびインターロイキン-６（ＩＬ-６）に対するリンゲルピルビン酸ナトリウム溶液の影響を調べる。

OBJECTIVE: To study the effects of Ringer's sodium pyruvate solution on tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) upon septic shock.

方法:

敗血症性ショックの救急患者90例を無作為抽選により治療群と対照群に分けた。対照群には複合塩化ナトリウム（リンゲル液）50mlを、治療群にはピルビン酸ナトリウム水溶液（リンゲル液）50mlを投与して蘇生させた。両群とも基本的には治療を行った。

METHODS: Ninety emergency patients with septic shock were divided into a treatment group and a control group by random draw. The control group was resuscitated with 50 ml of compound sodium chloride (Ringer's solution), and the treatment group was given 50 ml of Ringer's sodium pyruvate solution. Both groups were basically treated.

結果:

すべての患者さんが無事に蘇生されました。治療後、両群の血管外肺水指数、胸腔内血量指数、全身血管抵抗指数、心拍数は治療前と比較して有意に改善した(P<0.05)。しかし、異なる時点では有意な群間差は認められなかった（P>0.05）。血中乳酸値、中心静脈酸素飽和度指数、尿量も治療後に改善し、有意な群間差が認められた(P<0.05)。両群の血清TNF-α、IL-6レベルは治療後に有意に低下し（P<0.05）、治療群は対照群に比べて有意に低下した（P<0.05）。28日間の追跡期間中、治療群の死亡率（4.4％）は対照群（20.0％）に比べて有意に低かった（P<0.05）。

RESULTS: All patients were successfully resuscitated. After treatment, extravascular lung water index, intrathoracic blood volume index, systemic vascular resistance index and cardiac index of the two groups were significantly improved compared with those before treatment (P<0.05). However, there were no significant inter-group differences at different time points (P>0.05). Blood lactic acid level, central venous oxygen saturation index and urine output were also improved after treatment, with significant inter-group differences (P<0.05). Serum TNF-α and IL-6 levels of both groups significantly decreased after treatment (P<0.05), and the levels of the treatment group were significantly lower than those of the control group (P<0.05). During 28 days of follow-up, the mortality rate of the treatment group (4.4%) was significantly lower than that of the control group (20.0%) (P<0.05).

結論:

敗血症性ショックの患者は、炎症因子の発現が乱れていることが複雑に絡み合っている。蘇生の際、リンゲルピルビン酸ナトリウム溶液は効果的に血行を促進し、炎症を緩和し、酸塩基平衡を維持し、予後死亡率を低下させることができます。

CONCLUSION: Patients with septic shock are complicated with disordered expressions of inflammatory factors. During resuscitation, Ringer's sodium pyruvate solution can effectively promote blood circulation, mitigate inflammation and maintain acid-base equilibrium, thus decreasing the prognostic mortality rate.