血液净化联合乌司他丁治疗对脓毒症合并急性肺损伤患者外周血HMGB1、IL⁃6、IL⁃17和IL⁃33的影响

李寿彭; 孟磊

doi:10.14188/j.1671-8852.2023.0030

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血液净化联合乌司他丁治疗对脓毒症合并急性肺损伤患者外周血HMGB1、IL⁃6、IL⁃17和IL⁃33的影响

基础及临床医学研究 | 更新时间：2026-11-05

- 血液净化联合乌司他丁治疗对脓毒症合并急性肺损伤患者外周血HMGB1、IL⁃6、IL⁃17和IL⁃33的影响
- Effects of blood purification combined with ulinastatin on HMGB1, IL⁃6, IL⁃17, and IL⁃33 in peripheral blood of patients with sepsis complicated with acute lung injury
- 武汉大学学报（医学版） 2025年46卷第4期页码：474-479
- 作者机构：
  
  1.武汉市第三医院/武汉大学附属同仁医院急诊医学科湖北武汉 430060
  2.武汉同济航天城医院重症医学科湖北武汉 430056
- 作者简介：
  
  李寿彭，男，1978—，医学硕士，副主任医师，主要从事中毒、脓毒症、肺损伤、急危重症等疾病的基础与临床研究， E⁃mail：604911775@qq.com
  孟磊，男，1976—，副主任医师，主要从事急危重症医学相关研究， E⁃mail：2539565117@qq.com
- 基金信息：
  
  湖北省自然科学基金资助项目(2023AFB843)
- DOI：10.14188/j.1671-8852.2023.0030
  中图分类号： R432.6
- 收稿：2023-01-16，
  
  纸质出版：2025-04-25
- 稿件说明：
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李寿彭,孟磊.血液净化联合乌司他丁治疗对脓毒症合并急性肺损伤患者外周血HMGB1、IL⁃6、IL⁃17和IL⁃33的影响[J].武汉大学学报（医学版）,2025,46(04):474-479.

LI Shoupeng,MENG Lei.Effects of blood purification combined with ulinastatin on HMGB1, IL⁃6, IL⁃17, and IL⁃33 in peripheral blood of patients with sepsis complicated with acute lung injury[J].Medical Journal of Wuhan University,2025,46(04):474-479.
李寿彭,孟磊.血液净化联合乌司他丁治疗对脓毒症合并急性肺损伤患者外周血HMGB1、IL⁃6、IL⁃17和IL⁃33的影响[J].武汉大学学报（医学版）,2025,46(04):474-479. DOI： 10.14188/j.1671-8852.2023.0030.

LI Shoupeng,MENG Lei.Effects of blood purification combined with ulinastatin on HMGB1, IL⁃6, IL⁃17, and IL⁃33 in peripheral blood of patients with sepsis complicated with acute lung injury[J].Medical Journal of Wuhan University,2025,46(04):474-479. DOI： 10.14188/j.1671-8852.2023.0030.

摘要

目的

探讨应用血液净化联合乌司他丁对脓毒症合并急性肺损伤（ALI）的效果。

方法

选取武汉市第三医院/武汉大学附属同仁医院重症医学科2020年3月至2021年8月收治的84例脓毒症合并ALI者为研究对象，按治疗方法不同，分成观察组（

=42）、对照组（

=42）。两组患者均给予常规治疗，对照组在此基础上采取持续血液净化治疗，而观察组则在对照组基础上同时给予乌司他丁，比较各组患者治疗效果、治疗前与治疗10 d的血清炎症指标[高迁移率族蛋白B1（HMGB1）、白细胞介素⁃6（IL⁃6）、白细胞介素⁃17（IL⁃17）、白细胞介素⁃33（IL⁃33）

]

、血气指标[血氧饱和度（SaO

）、动脉血氧分压（PaO

）、动脉血二氧化碳分压（PaCO

）、氧合指数（OI）

]

、肺功能指标[第1秒用力呼气容积（FEV

）、用力肺活量（FVC）、FEV

/FVC

]

水平；治疗前后采取急性生理功能和慢性健康状况评分系统Ⅱ(APACHE Ⅱ)、序贯器官衰竭评分（SOFA）评价患者病情严重程度。

结果

总有效率观察组高，同对照组差异有统计学意义（

0.05）。两组在治疗后10 d的HMGB1、IL⁃6、IL⁃17、IL⁃33、PaCO

、APACHE Ⅱ评分、SOFA评分降低，且观察组指标比对照组低（

0.05）；而两组SaO

、PaO

、FEV

、FVC、FEV

/FVC指标较治疗前提高，且观察组指标高于对照组（

0.05）。

结论

应用血液净化联合乌司他丁治疗脓毒症合并ALI患者效果满意，有效改善炎症指标、血气指标及肺功能指标，减轻患者病情严重程度，值得推广。

Abstract

Objective

To investigate the effect of blood purification combined with ulinastatin on sepsis complicated with acute lung injury (ALI).

Methods

A total of

84 patients with sepsis complicated with ALI were treated from March 2020 to August 2021 at Wuhan Third Hospital and Tongren Hospital of Wuhan University. These patients were included in this study and divided into an observation group (

=42) and a control group (

=42) based on different treatment methods. Patients in both groups were given conventional treatment. The control group received continuous blood purification treatment in addition to the conventional treatment

while the observation group received ulinastatin treatment in addition to the control group's treatment.The therapeutic effect

serum inflammation indexes (high mobility group protein B1 (HMGB1)

interleukin⁃6 (IL⁃6)

interleukin⁃17 (IL⁃17)

and interleukin⁃33 (IL⁃33))

blood gas indexes (blood oxygen saturation (SaO

)

arterial partial pressure of oxygen (PaO

)

arterial partial pressure of carbon dioxide (PaCO

)

and oxygenation index (OI))

and pulmonary function indicators (forced expiratory volume in the first second (FEV

)

forced vital capacity (FVC)

and FEV

/FVC)were compared. Acute Physiological Function and Chronic Health Status Score System Ⅱ(APACHE Ⅱ) and Sequential Organ Failure Score (SOFA) were used to evaluate the severity of the patients before and after treatment.

Results

The overall effective rate of the observation group was higher than that of the control group (

0.05). After 10 days of treatment

HMGB1

IL⁃6

IL⁃17

IL⁃33

PaCO

APACHE Ⅱ scores

and SOFA scores in both groups were significantly reduced. These indicators were significantly lower in the observation group than in the control group (

0.05). In contrast

the indexes of SaO

PaO

FEV

FVC and FEV

/FVC in both groups were significantly increased after 10 days of treatment. These indexes were significantly higher in the observation group tha

n in the control group (

0.05).

Conclusion

Blood purification combined with ulinastatin is effective in the treatment of sepsis and ALI patients

especially in improving inflammation indexes

blood gas indexes and lung function indexes

and reducing the severity of patients' disease

thereby deserving further application.

关键词

Keywords

references

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