摘要
目的研究重症社区获得性肺炎患者使用血必净治疗后对机体炎症调节效果,并分析药物作用机制。方法研究拟采用单中心随机对照,随机抽签法自2018年1~12月重症社区获得性肺炎住院患者中抽取100例,随机将其分为两组,干预组与对照组各50例。对照组在常规治疗基础上加生理盐水50mL静滴1次/12h,干预组在常规治疗基础上加血必净注射液50mL静滴1次/12h,观察两组患者治疗前、中、后血清及肺泡灌洗液炎症介质的水平变化,治疗后症状缓解情况、死亡率(28d)指标。结果干预组治疗后INF-γ、IL-10指标显著高于对照组,IL-2、IL-6、PCT指标显著低于对照组,干预组患者治疗后PSI、APACHEⅡ、SOFA评分、呼吸机使用时间均低于对照组,干预组患者28d死亡率显著低于对照组,差异有统计学意义(P<0.05)。结论重症社区获得性肺炎患者进行治疗的过程中使用血必净,可有效改善血清、肺泡灌洗液炎性介质,控制肺炎症状,整体治疗效果理想,降低死亡率。
Objective To study the effects of Xuebijing on inflammatory regulation in patients with severe community-acquired pneumonia,and to analyze the mechanism of drug action.Methods The study was designed to use a single-center randomized control.100 hospitalized patients with severe community-acquired pneumonia from January to December 2018 were selected by random drawing method,and divided into two groups according to the random grouping method,the intervention group and the control group,with 50 patients in each group.The control group was given intravenous infusion of 50mL of normal saline once per 12 hours on the basis of conventional therapy,while the intervention group was given intravenous infusion of 50mL of Xuebijing injection once per 12 hours on the basis of conventional therapy.The changes in the levels of inflammatory mediators in serum and alveolar lavage fluid before,during and after treatment,as well as the symptom relief and mortality(28d)indexes after treatment in the two groups of patients were observed.Results After treatment,INF-γand IL-10 indexes in the intervention group were significantly higher than those in the control group,while IL-2,IL-6 and PCT indexes were significantly lower than those in the control group;after treatment,the PSI score,APACHEⅡscore,SOFA score,and ventilator use time of patients in the intervention group were all lower than those in the control group,and the mortality at 28d of patients in the intervention group was significantly lower than that in the control group,with statistically significant difference(P<0.05).Conclusion The use of Xuebijing in the treatment of patients with severe community-acquired pneumonia can effectively improve the inflammatory mediators in serum and alveolar lavage fluid,control pneumonia symptoms,achieve an ideal overall therapeutic effect,and reduce mortality.
作者
张海晖
刘世专
黄炳才
陈时松
黄业枢
ZHANG Haihui;LIU Shizhuan;HUANG Bingcai;CHEN Shisong;HUANG Yeshu(Department of Critical Care Medicine,Yangchun People’s Hospital of Guangdong province,Guangdong,Yangchun 529600,China)
出处
《中国医药科学》
2020年第11期183-185,共3页
China Medicine And Pharmacy
基金
广东省阳江市医疗卫生类科技计划项目(阳科通[2019]50号-122)。
关键词
血必净
重症社区获得性肺炎
炎症调控机制
临床疗效
Xuebijing
Severe community-acquired pneumonia
Inflammatory regulation mechanism
Clinical efficacy
