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[目的]研究拟胆碱药卡巴胆碱对危重病人血浆细胞因子的影响及其意义。[方法]选取2007年2月～2009年12月唐山市3家综合性三级医院ICU172例胃肠功能障碍患者为研究对象,随机分为对照组(42例)卡巴胆碱组(67例)和莫沙比利组(63例),分别给予不同治疗后,不同时间点测定外周血炎性细胞因子的水平。[结果]随着治疗的进行,各组血浆细胞因子均有下降之势,卡巴胆碱组不同时间点相比差异有统计学意义(P﹤0.05),而其他两组不同时间点相比差异无统计学意义(P﹥0.05)。同时,相同时间点卡巴胆碱组和莫沙比利组血浆CRP、IL-6、TNF-α水平亦均有不同程度下降,卡巴胆碱组与其他两组相比差异均有统计学意义(P﹤0.05),但莫沙比利组与对照组相比差异无统计学意义(P﹥0.05)。[结论]卡巴胆碱能抑制危重病人体内炎性细胞因子的产生,在改善胃肠道缺血和炎症反应方面具有潜在的价值。
[Objective] To study the effect of carbachol choline on plasma cytokines in critically ill patients and its significance. [Methods] A total of 172 gastrointestinal dysfunction patients in ICU from 3 comprehensive tertiary hospitals in Tangshan City from February 2007 to December 2009 were selected as research object and randomly divided into control group (n = 42), carbachol group (n = 67) And mosapride (63 cases) were given different levels of peripheral blood inflammatory cytokines at different time points. [Results] As the treatment progressed, the plasma cytokines decreased in all groups, and the difference was statistically significant at different time points in carbachol group (P <0.05), while the difference between the other two groups at different time points No statistical significance (P> 0.05). At the same time, plasma CRP, IL-6 and TNF-α levels in carbachol group and mosapride group also decreased to different extents at the same time point, and there was significant difference between carbachol group and other two groups P <0.05), but there was no significant difference between mosapride group and control group (P> 0.05). [Conclusion] Carbachol can inhibit the production of inflammatory cytokines in critically ill patients and has potential value in improving gastrointestinal ischemia and inflammatory reaction.