摘要
目的:探讨血必净注射液联合低分子肝素对脓毒症患者的治疗效果及对免疫功能和炎性因子的影响。方法:选择江苏省常州市武进中医医院2018年1月至2019年12月收治的脓毒症患者60例,依据随机数字表法分为观察组30例与对照组30例。对照组患者给予低分子肝素钠治疗;观察组患者给予血必净注射液联合低分子肝素治疗,两组疗程均为1周,比较两组治疗前和治疗后心率(HR)、体温、呼吸频率、白细胞计数(WBC)、全身感染相关性器官功能衰竭量表(SOFA)和急性生理学与慢性健康状况评估(APACHE)Ⅱ评分以及免疫功能和炎性因子肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)和白细胞介素-6(IL-6)水平的变化。结果:观察组治疗后HR、体温、呼吸频率和WBC均低于对照组[(83.22±4.34)次/min比(89.14±3.67)次/min、(37.02±0.37)℃比(37.81±0.4)℃、(86.83±4.56)次/min比(97.32±6.17)次/min、(10.85±1.28)×10^9/L比(12.29±1.34)×10^9/L],差异有统计学意义(t=5.705、7.330、7.489、4.256,P<0.05)。观察组治疗后SOFA评分和APACHEⅡ评分均低于对照组[(8.93±1.42)分比(13.24±1.98)分、(12.13±2.19)分比(15.52±1.98)分],差异有统计学意义(t=9.689、6.289,P<0.05)。观察组治疗后CD 3^+、CD 3^+CD 4^+和CD 4^+/CD 8^+高于对照组[(62.31±5.21)%比(54.68±3.75)%、(35.38±2.98)%比(29.39±3.10)%、1.15±0.24比1.47±0.18],差异有统计学意义(t=6.510、7.630、7.050,P<0.05)。观察组治疗后血清TNF-α、CRP和IL-6水平低于对照组[(23.94±4.63)μg/L比(37.91±3.6)μg/L、(43.17±9.93)mg/L比(75.23±15.42)mg/L、(34.21±4.28)μg/L比(48.93±5.12)μg/L],差异有统计学意义(t=12.978、9.574、12.082,P<0.05)。结论:血必净注射液联合低分子肝素可降低脓毒血症患者的HR、体温、呼吸频率和WBC,减轻患者的病情和器官损伤,提高机体的免疫功能,减轻体内的炎性反应。
Objective To investigate the effect of Xuebijing injection combined with low-molecular-weight heparin on the immune function and inflammatory factors in patients with sepsis.Methods The clinical data of 60 patients with sepsis admitted in the department of intensive care unit of Changzhou Wujin Hospital of Traditional Chinese Medicine from January 2018 to December 2019 were analyzed.The patients were randomly divided into observation group(30 cases)and control group(30 cases).The control group was treated with low-molecular-weight heparin sodium;the observation group was given Xuebijing injection combined with low-molecular-weight heparin.The course of treatment was 1 week in both groups.Heart rate(HR),body temperature,respiratory rate and white blood cell count(WBC),systemic infection related organ failure scale(SOFA)score,acute physiology and chronic health evaluation(APACHE)Ⅱscore,immune function and inflammatory factors tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)and interleukin-6(IL-6)were compared between the two groups before and after treatment for 1 week.Results After treatment,the levels of HR,body temperature,respiratory rate and WBC in the observation group were lower than those in the control group[(83.22±4.34)beats/min vs.(89.14±3.67)beats/min,(37.02±0.37)℃vs.(37.81±0.4)℃,(86.83±4.56)times/min vs.(97.32±6.17)times/min,(10.85±1.28)×10^9/L vs.(12.29±1.34)×10^9/L],and the differences were statistically significant(t=5.705,7.330,7.489,4.256,P<0.05).After treatment,the scores of SOFA and APACHEⅡin the observation group were lower than those in the control group[(8.93±1.42)scores vs.(13.24±1.98)scores,(12.13±2.19)scores vs.(15.52±1.98)scores],and the differences were statistically significant(t=9.689,6.289,P<0.05).After treatment,the levels of CD3^+,CD3^+CD4^+and CD4^+/CD8^+in the observation group were higher than those in the control group[(62.31±5.21)%vs.(54.68±3.75)%,(35.38±2.98)%vs.(29.39±3.10)%,1.15±0.24 vs.1.47±0.18],and the differences were statistically sig
作者
李洪
蒋红英
庄乐
周丹
陆岑琳
Li Hong;Jiang Hongying;Zhuang Le;Zhou Dan;Lu Cenlin
出处
《中国医师进修杂志》
2020年第12期1069-1073,共5页
Chinese Journal of Postgraduates of Medicine
