A. N. Tulupov, M. I. Gromov, L. Pivovarova, A. V. Nikitin, V. N. Lapshin, O. Ariskina, I. V. Osipova, A. V. Fedorov
{"title":"使用原生脱氧核糖核酸药物预防严重合并损伤患者的感染并发症","authors":"A. N. Tulupov, M. I. Gromov, L. Pivovarova, A. V. Nikitin, V. N. Lapshin, O. Ariskina, I. V. Osipova, A. V. Fedorov","doi":"10.24884/2072-6716-2024-25-2-51-59","DOIUrl":null,"url":null,"abstract":"The objective of the study: improve the course of traumatic disease and reduce the number of complications in victims with severe combined injury (SCI). Material and methods. Included were 60 patients with SCI who were consecutively admitted to a level I trauma center with shock of II or III severity and a positive prognosis for life. Design: double-blind, placebo-controlled, single-center study. For an additional 10 days in a row, starting from the 2nd day, all victims were injected once daily intramuscularly with 5 ml of a 0.015% solution of sodium deoxyribonucleate or placebo (saline solution). Results. The final distribution into groups: I main (27 people) — with the drug and II comparison (27 people) — with placebo. The groups did not differ in gender, age, severity of injury and shock, or treatment received. In 48% I group and 52% II group complications developed. Their sum (21) in I group was less than in II group (39), p=0.102. The reduction was achieved due to infectious non-life-threatening complications (gr. I — 1, gr. II — 12, p=0.001). Duration of anemia in days (blood hemoglobin <100 g/l) in I group was less (175 days) compared to group II. (316 days), p=0.010. Similarly, for hypoproteinemia (total protein <60 g/l): the sum of days in I group less (199 days) than in group II (343 days), p=0.036. In the subgroups with complications, after 7–14 days, the number of stem cells in the blood that stimulate healing increased only in patients of group I (CD117+ by 290%, p=0.000 and CD34+ by 200%, p=0.034). Also, only in them did the content of functionally mature neutrophilic granulocytes (NG) containing antimicrobial defensins (Def+NG) increase by 26%, p=0.019. Died in I group — 1 person, in II group — 2. Duration of hospitalization in group I — 32.8±4.1 days, in II group — 39.6±6.6 days. Conclusion. Administration of sodium deoxyribonucleate increases the number of stem cells and Def+NG in the blood, reduces the duration of anemia and hypoproteinemia, which leads to a reduction in the number of complications and treatment time for victims with SCI.","PeriodicalId":517874,"journal":{"name":"EMERGENCY MEDICAL CARE","volume":" 11","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prevention of infectious complications in patients with severe combined injury using native deoxyribonucleic acid drug\",\"authors\":\"A. N. Tulupov, M. I. Gromov, L. Pivovarova, A. V. Nikitin, V. N. Lapshin, O. Ariskina, I. V. Osipova, A. V. Fedorov\",\"doi\":\"10.24884/2072-6716-2024-25-2-51-59\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"The objective of the study: improve the course of traumatic disease and reduce the number of complications in victims with severe combined injury (SCI). Material and methods. Included were 60 patients with SCI who were consecutively admitted to a level I trauma center with shock of II or III severity and a positive prognosis for life. Design: double-blind, placebo-controlled, single-center study. For an additional 10 days in a row, starting from the 2nd day, all victims were injected once daily intramuscularly with 5 ml of a 0.015% solution of sodium deoxyribonucleate or placebo (saline solution). Results. The final distribution into groups: I main (27 people) — with the drug and II comparison (27 people) — with placebo. The groups did not differ in gender, age, severity of injury and shock, or treatment received. In 48% I group and 52% II group complications developed. Their sum (21) in I group was less than in II group (39), p=0.102. The reduction was achieved due to infectious non-life-threatening complications (gr. I — 1, gr. II — 12, p=0.001). Duration of anemia in days (blood hemoglobin <100 g/l) in I group was less (175 days) compared to group II. (316 days), p=0.010. Similarly, for hypoproteinemia (total protein <60 g/l): the sum of days in I group less (199 days) than in group II (343 days), p=0.036. In the subgroups with complications, after 7–14 days, the number of stem cells in the blood that stimulate healing increased only in patients of group I (CD117+ by 290%, p=0.000 and CD34+ by 200%, p=0.034). Also, only in them did the content of functionally mature neutrophilic granulocytes (NG) containing antimicrobial defensins (Def+NG) increase by 26%, p=0.019. Died in I group — 1 person, in II group — 2. Duration of hospitalization in group I — 32.8±4.1 days, in II group — 39.6±6.6 days. Conclusion. Administration of sodium deoxyribonucleate increases the number of stem cells and Def+NG in the blood, reduces the duration of anemia and hypoproteinemia, which leads to a reduction in the number of complications and treatment time for victims with SCI.\",\"PeriodicalId\":517874,\"journal\":{\"name\":\"EMERGENCY MEDICAL CARE\",\"volume\":\" 11\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-07-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"EMERGENCY MEDICAL CARE\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.24884/2072-6716-2024-25-2-51-59\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"EMERGENCY MEDICAL CARE","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.24884/2072-6716-2024-25-2-51-59","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
研究目的:改善严重合并损伤(SCI)患者的创伤性疾病病程,减少并发症数量。材料和方法。纳入 60 名连续入住一级创伤中心、休克程度为 II 或 III 且预后良好的 SCI 患者。设计:双盲、安慰剂对照、单中心研究。从第 2 天开始,所有患者连续 10 天每天肌肉注射一次 5 毫升 0.015%的脱氧核糖核酸钠溶液或安慰剂(生理盐水)。结果最终的分组情况如下I 主组(27 人)--使用药物,II 对比组(27 人)--使用安慰剂。两组在性别、年龄、受伤和休克的严重程度或接受的治疗方面没有差异。48% 的 I 组和 52% 的 II 组出现了并发症。I 组的并发症总数(21 例)少于 II 组(39 例),P=0.102。并发症减少的原因是感染性非致命并发症(I 组 1 例,II 组 12 例,P=0.001)。与第二组相比,第一组的贫血持续时间(血红蛋白小于 100 克/升)较短(175 天)(316 天),P=0.001。(316天),P=0.010。同样,对于低蛋白血症(总蛋白低于 60 克/升):I 组的天数总和(199 天)少于 II 组(343 天),P=0.036。在有并发症的亚组中,7-14 天后,只有 I 组患者血液中促进愈合的干细胞数量增加(CD117+ 增加 290%,p=0.000;CD34+ 增加 200%,p=0.034)。此外,只有他们体内含有抗菌防御素(Def+NG)的功能成熟的中性粒细胞(NG)含量增加了 26%,P=0.019。I 组死亡 1 人,II 组死亡 2 人。I 组住院时间为(32.8±4.1)天,II 组住院时间为(39.6±6.6)天。结论脱氧核糖核酸钠能增加血液中干细胞和Def+NG的数量,缩短贫血和低蛋白血症的持续时间,从而减少脊髓损伤患者的并发症数量和治疗时间。
Prevention of infectious complications in patients with severe combined injury using native deoxyribonucleic acid drug
The objective of the study: improve the course of traumatic disease and reduce the number of complications in victims with severe combined injury (SCI). Material and methods. Included were 60 patients with SCI who were consecutively admitted to a level I trauma center with shock of II or III severity and a positive prognosis for life. Design: double-blind, placebo-controlled, single-center study. For an additional 10 days in a row, starting from the 2nd day, all victims were injected once daily intramuscularly with 5 ml of a 0.015% solution of sodium deoxyribonucleate or placebo (saline solution). Results. The final distribution into groups: I main (27 people) — with the drug and II comparison (27 people) — with placebo. The groups did not differ in gender, age, severity of injury and shock, or treatment received. In 48% I group and 52% II group complications developed. Their sum (21) in I group was less than in II group (39), p=0.102. The reduction was achieved due to infectious non-life-threatening complications (gr. I — 1, gr. II — 12, p=0.001). Duration of anemia in days (blood hemoglobin <100 g/l) in I group was less (175 days) compared to group II. (316 days), p=0.010. Similarly, for hypoproteinemia (total protein <60 g/l): the sum of days in I group less (199 days) than in group II (343 days), p=0.036. In the subgroups with complications, after 7–14 days, the number of stem cells in the blood that stimulate healing increased only in patients of group I (CD117+ by 290%, p=0.000 and CD34+ by 200%, p=0.034). Also, only in them did the content of functionally mature neutrophilic granulocytes (NG) containing antimicrobial defensins (Def+NG) increase by 26%, p=0.019. Died in I group — 1 person, in II group — 2. Duration of hospitalization in group I — 32.8±4.1 days, in II group — 39.6±6.6 days. Conclusion. Administration of sodium deoxyribonucleate increases the number of stem cells and Def+NG in the blood, reduces the duration of anemia and hypoproteinemia, which leads to a reduction in the number of complications and treatment time for victims with SCI.