目的观察并探讨乌司他丁联合血必净注射液治疗老年重症肺炎的临床疗效。方法入选2013年6月至2015年4月青岛大学附属医院急诊科收治的重症肺炎患者96例,根据随机数字表法分为联合组(49例)与对照组(47例)。两组患者均给予综合对症治疗,对...目的观察并探讨乌司他丁联合血必净注射液治疗老年重症肺炎的临床疗效。方法入选2013年6月至2015年4月青岛大学附属医院急诊科收治的重症肺炎患者96例,根据随机数字表法分为联合组(49例)与对照组(47例)。两组患者均给予综合对症治疗,对照组加用血必净注射液,100 m L血必净注射液加入200 m L 0.9%Na Cl注射液静脉滴注,每日2次,联合组在对照组基础上加用乌司他丁注射液,20万U乌司他丁加入50 m L 0.9%Na Cl注射液微量泵泵注,每日2次,疗程均为14 d,记录病死情况与有创通气比例,对比治疗前后动脉血气指标与外周血炎性介质浓度,比较临床疗效。结果联合组治疗后动脉血氧分压、动脉血二氧化碳分压、氧合指数均显著优于对照组[(98±10)mm Hg(1 mm Hg=0.133 k Pa)比(92±9)mm Hg,(41±4)mm Hg比(43±3)mm Hg,(283±40)比(243±37),P<0.01]。联合组治疗后肿瘤坏死因子α、白细胞介素6、白细胞介素8、C反应蛋白均显著低于对照组[(22±8)ng/L比(38±12)ng/L、(56±15)ng/L比(68±17)ng/L、(59±10)ng/L比(69±11)ng/L、(12±3)mg/L比(17±5)mg/L,P<0.01]。联合组与对照组治疗中行有创通气比例、病死率差异无统计学意义(P>0.05);联合组与对照组总有效率比较差异无统计学意义(P>0.05)。结论血必净与乌司他丁在重症肺炎抗炎治疗中作用协同,联合应用较之单纯应用血必净注射液可进一步抑制炎症反应,改善肺氧合功能,改善治疗效果。展开更多
AIM： To investigate the effect of shenfu injection on gastrointestinal microcirculation after myocardial ischemic-reperfusion （IR） injury in rabbits and probe into the mechanism. METHODS： Forty healthy flap-eared ...AIM： To investigate the effect of shenfu injection on gastrointestinal microcirculation after myocardial ischemic-reperfusion （IR） injury in rabbits and probe into the mechanism. METHODS： Forty healthy flap-eared white rabbits were randomly divided into 4 groups： IR injury control group （group Ⅰ ）, shenfu injection 5 mL/kg per h group （group Ⅱ）, shenfu injection 10 mL/kg per h group （group Ⅲ） and shenfu injection 20 mL/kg per h group （group Ⅳ）. The four groups were treated with Lactated Ringer＇s solution, shenfu injection 5, 10, and 20 mL/ kg per h were infused intravenously 30 min before experiment respectively. The values of hemodynamics [mean arterial pressure （MAP）, heart rate （HR）, gastric intramucosal partial pressure of carbon dioxide （PCO2）, blood gas analysis and pH] were measured and compared with those before myocardial ischemia, 60 min after myocardial ischemia and 60, 90, and 180 rain after reperfusion. RESULTS： The MAP, HR and gastric intramucosal pH were （70.50 ± 4.50） kPa, （165 ± 14） beats per rain, 7.032 ± 0.024 in group Ⅰ 60 min after myocardial ischemia, which were significantly decreased compared with those before myocardial ischemia （88.50 ± 9.75 kPa, 217 ± 18 beats per rain, 7.112 ± 0.035, P 〈 0.05）. The MAP, HR and gastric intramucosal pH were significantly decreased in group Ⅰ 60, 90, and 180 min after reperfusion （61.50 ± 5.25 kPa, 133 ± 31 beats per rain, 6.997 ± 0.025） compared with those before reperfusion respectively （P 〈 0.05）, whereas the values were insignificantly different in groups Ⅱ, Ⅲ or Ⅳ after reperfusion, compared with those before reperfusion, and there were no significant differences between groups Ⅱ, Ⅲ, and Ⅳ after reperfusion. CONCLUSION： Pre-infusion of shenfu injection has a protective effect on gastrointestinal microcirculation after myocardial IR injury in rabbits, in a dose independent manner.展开更多
Objective： To evaluate the efficacy of Xuebijing Injection（血必净注射液, XBJ） on the lung injury induced by cardiopulmonary bypass（CPB）. Methods： Fifty patients undergoing CPB were randomized to either the salin...Objective： To evaluate the efficacy of Xuebijing Injection（血必净注射液, XBJ） on the lung injury induced by cardiopulmonary bypass（CPB）. Methods： Fifty patients undergoing CPB were randomized to either the saline group or XBJ group according to a random number table（25 cases in each group）. The patients in the saline group received saline and patients in XBJ group received XBJ at 12 h prior to the operation, at the beginning of the operation, and at 12 h after the second injection. The PaO_2/Fi O2 at extubation 3 days post-operation, duration of ventilation in the intensive care unit（ICU）, and lengths of stay in the ICU and hospital were recorded. The levels of inflammatory mediators including interleukin（IL）-1β, IL-8, IL-10, and C-reactive protein（CRP） in bronchoalveolar lavage fluid（BALF） and plasma were measured. The neutrophil count and elastase neutrophil elastase in BALF were also measured. In addition, adverse events were monitored. Results： The PaO-2/FiO_2 in the XBJ group was higher than that in the saline group from 12 to 72 h post-operation（all P〈0.05）. The blood levels of IL-1β, IL-8, and CRP in the XBJ group from 12 to 72 h were all significantly lower than those in the saline group（all P〈0.05）. In contrast, the level of the anti-inflammatory cytokine IL-10 was significantly higher in the XBJ group than in the saline group（P〈0.05）. In addition, 4 patients presented with atelectasis in the saline group and none in the XBJ group. Ten patients experienced mild acute respiratory distress syndrome（ARDS） during hospitalization, and 5 patients with mild ARDS were in the XBJ group（P〈0.05）. Conclusion： XBJ shows protective potential against lung injury in patients who undergo CPB surgery, possibly through the downregulation of inflammatory mediators, reduction in neutrophil infiltration, and upregulation of IL-10（Trial registry： Chi CTR-TRC-14004628）.展开更多
目的通过猪心脏骤停窒息模型探讨参附注射液对此类肺损伤保护作用的可能机制。方法34只健康近交系五指山小型猪使用气管插管夹闭方法制作窒息型心脏骤停动物模型及行标准的心肺复苏术,其中18只成功恢复自主循环(return of spontaneous c...目的通过猪心脏骤停窒息模型探讨参附注射液对此类肺损伤保护作用的可能机制。方法34只健康近交系五指山小型猪使用气管插管夹闭方法制作窒息型心脏骤停动物模型及行标准的心肺复苏术,其中18只成功恢复自主循环(return of spontaneous circulation,ROSC),使用随机数字表法分为两组:参附组(n=9):于ROSC后即刻以参附注射液0.24mg/min的剂量持续静脉泵入直至复苏后6h;盐水组(n=9):于ROSC后即刻持续静脉泵入相同剂量及速度的生理盐水直至复苏后6h。通过血气分析仪测量基础状态、ROSC即刻、ROSC后15min、30min、1h、2h、4h及6h的氧代谢及呼吸力学指标[包括:氧合指数(OI)、呼吸指数(RI)、氧输送(DO2)、氧消耗(VO2)、氧摄取(O2ER)、二氧化碳分压(PaCO2)及血乳酸(LAC),并监测同一时刻动物的肺顺应性(Cdyn)、气道阻力(Raw)、血管外肺水指数(EVLWI)和肺血管通透性指数(PVPI)];酶联免疫吸附法测定Na+-K+-ATP酶活性、Ca2+-ATP酶活性、SOD及MDA含量、TNF-α、IFN-γ和IL-4浓度,计算IFN-γ/IL-4值;利用TUNEL法检测细胞凋亡并计算凋亡指数(AI);免疫组织化学法检测Bcl-2、Bax蛋白浓度,计算BAX/BCL-2值;Western blot法检测Caspase-3蛋白定量。结果至ROSC后6h,参附组存活率为88.9%(8/9),盐水组存活率为66.7%(6/9);参附组平均生存时间(5.77±0.71)h长于盐水组(4.77±0.59)h,两组比较差异无统计学意义(P>0.05)。与基础状态比较,两组的OI和Cdyn在ROSC即刻明显降低(P<0.05),而RI、DO_2、VO_2、O_2ER、Raw、EVLWI、PVPI、PaCO_2和LAC在ROSC即刻则显著升高(P<0.05),各指标不论升高或降低均随时间延长而恢复;与盐水组比较,参附组在ROSC后的各个时间点,OI、Cdyn、DO_2、VO_2和O2ER显著高于盐水组(P<0.05,P<0.01),而RI、Raw、EVLWI、PVPI、PaCO_2和LAC则低于盐水组(P<0.05,P<0.01)。与盐水组比较,参附组Na^+-K^+-ATP酶、Ca^(2+)-ATP酶、SOD水平、IFN-γ水平、IFN-γ/IL-4值及Bcl-2浓度升高,而M展开更多
文摘目的观察并探讨乌司他丁联合血必净注射液治疗老年重症肺炎的临床疗效。方法入选2013年6月至2015年4月青岛大学附属医院急诊科收治的重症肺炎患者96例,根据随机数字表法分为联合组(49例)与对照组(47例)。两组患者均给予综合对症治疗,对照组加用血必净注射液,100 m L血必净注射液加入200 m L 0.9%Na Cl注射液静脉滴注,每日2次,联合组在对照组基础上加用乌司他丁注射液,20万U乌司他丁加入50 m L 0.9%Na Cl注射液微量泵泵注,每日2次,疗程均为14 d,记录病死情况与有创通气比例,对比治疗前后动脉血气指标与外周血炎性介质浓度,比较临床疗效。结果联合组治疗后动脉血氧分压、动脉血二氧化碳分压、氧合指数均显著优于对照组[(98±10)mm Hg(1 mm Hg=0.133 k Pa)比(92±9)mm Hg,(41±4)mm Hg比(43±3)mm Hg,(283±40)比(243±37),P<0.01]。联合组治疗后肿瘤坏死因子α、白细胞介素6、白细胞介素8、C反应蛋白均显著低于对照组[(22±8)ng/L比(38±12)ng/L、(56±15)ng/L比(68±17)ng/L、(59±10)ng/L比(69±11)ng/L、(12±3)mg/L比(17±5)mg/L,P<0.01]。联合组与对照组治疗中行有创通气比例、病死率差异无统计学意义(P>0.05);联合组与对照组总有效率比较差异无统计学意义(P>0.05)。结论血必净与乌司他丁在重症肺炎抗炎治疗中作用协同,联合应用较之单纯应用血必净注射液可进一步抑制炎症反应,改善肺氧合功能,改善治疗效果。
文摘AIM： To investigate the effect of shenfu injection on gastrointestinal microcirculation after myocardial ischemic-reperfusion （IR） injury in rabbits and probe into the mechanism. METHODS： Forty healthy flap-eared white rabbits were randomly divided into 4 groups： IR injury control group （group Ⅰ ）, shenfu injection 5 mL/kg per h group （group Ⅱ）, shenfu injection 10 mL/kg per h group （group Ⅲ） and shenfu injection 20 mL/kg per h group （group Ⅳ）. The four groups were treated with Lactated Ringer＇s solution, shenfu injection 5, 10, and 20 mL/ kg per h were infused intravenously 30 min before experiment respectively. The values of hemodynamics [mean arterial pressure （MAP）, heart rate （HR）, gastric intramucosal partial pressure of carbon dioxide （PCO2）, blood gas analysis and pH] were measured and compared with those before myocardial ischemia, 60 min after myocardial ischemia and 60, 90, and 180 rain after reperfusion. RESULTS： The MAP, HR and gastric intramucosal pH were （70.50 ± 4.50） kPa, （165 ± 14） beats per rain, 7.032 ± 0.024 in group Ⅰ 60 min after myocardial ischemia, which were significantly decreased compared with those before myocardial ischemia （88.50 ± 9.75 kPa, 217 ± 18 beats per rain, 7.112 ± 0.035, P 〈 0.05）. The MAP, HR and gastric intramucosal pH were significantly decreased in group Ⅰ 60, 90, and 180 min after reperfusion （61.50 ± 5.25 kPa, 133 ± 31 beats per rain, 6.997 ± 0.025） compared with those before reperfusion respectively （P 〈 0.05）, whereas the values were insignificantly different in groups Ⅱ, Ⅲ or Ⅳ after reperfusion, compared with those before reperfusion, and there were no significant differences between groups Ⅱ, Ⅲ, and Ⅳ after reperfusion. CONCLUSION： Pre-infusion of shenfu injection has a protective effect on gastrointestinal microcirculation after myocardial IR injury in rabbits, in a dose independent manner.
文摘Objective： To evaluate the efficacy of Xuebijing Injection（血必净注射液, XBJ） on the lung injury induced by cardiopulmonary bypass（CPB）. Methods： Fifty patients undergoing CPB were randomized to either the saline group or XBJ group according to a random number table（25 cases in each group）. The patients in the saline group received saline and patients in XBJ group received XBJ at 12 h prior to the operation, at the beginning of the operation, and at 12 h after the second injection. The PaO_2/Fi O2 at extubation 3 days post-operation, duration of ventilation in the intensive care unit（ICU）, and lengths of stay in the ICU and hospital were recorded. The levels of inflammatory mediators including interleukin（IL）-1β, IL-8, IL-10, and C-reactive protein（CRP） in bronchoalveolar lavage fluid（BALF） and plasma were measured. The neutrophil count and elastase neutrophil elastase in BALF were also measured. In addition, adverse events were monitored. Results： The PaO-2/FiO_2 in the XBJ group was higher than that in the saline group from 12 to 72 h post-operation（all P〈0.05）. The blood levels of IL-1β, IL-8, and CRP in the XBJ group from 12 to 72 h were all significantly lower than those in the saline group（all P〈0.05）. In contrast, the level of the anti-inflammatory cytokine IL-10 was significantly higher in the XBJ group than in the saline group（P〈0.05）. In addition, 4 patients presented with atelectasis in the saline group and none in the XBJ group. Ten patients experienced mild acute respiratory distress syndrome（ARDS） during hospitalization, and 5 patients with mild ARDS were in the XBJ group（P〈0.05）. Conclusion： XBJ shows protective potential against lung injury in patients who undergo CPB surgery, possibly through the downregulation of inflammatory mediators, reduction in neutrophil infiltration, and upregulation of IL-10（Trial registry： Chi CTR-TRC-14004628）.
文摘目的通过猪心脏骤停窒息模型探讨参附注射液对此类肺损伤保护作用的可能机制。方法34只健康近交系五指山小型猪使用气管插管夹闭方法制作窒息型心脏骤停动物模型及行标准的心肺复苏术,其中18只成功恢复自主循环(return of spontaneous circulation,ROSC),使用随机数字表法分为两组:参附组(n=9):于ROSC后即刻以参附注射液0.24mg/min的剂量持续静脉泵入直至复苏后6h;盐水组(n=9):于ROSC后即刻持续静脉泵入相同剂量及速度的生理盐水直至复苏后6h。通过血气分析仪测量基础状态、ROSC即刻、ROSC后15min、30min、1h、2h、4h及6h的氧代谢及呼吸力学指标[包括:氧合指数(OI)、呼吸指数(RI)、氧输送(DO2)、氧消耗(VO2)、氧摄取(O2ER)、二氧化碳分压(PaCO2)及血乳酸(LAC),并监测同一时刻动物的肺顺应性(Cdyn)、气道阻力(Raw)、血管外肺水指数(EVLWI)和肺血管通透性指数(PVPI)];酶联免疫吸附法测定Na+-K+-ATP酶活性、Ca2+-ATP酶活性、SOD及MDA含量、TNF-α、IFN-γ和IL-4浓度,计算IFN-γ/IL-4值;利用TUNEL法检测细胞凋亡并计算凋亡指数(AI);免疫组织化学法检测Bcl-2、Bax蛋白浓度,计算BAX/BCL-2值;Western blot法检测Caspase-3蛋白定量。结果至ROSC后6h,参附组存活率为88.9%(8/9),盐水组存活率为66.7%(6/9);参附组平均生存时间(5.77±0.71)h长于盐水组(4.77±0.59)h,两组比较差异无统计学意义(P>0.05)。与基础状态比较,两组的OI和Cdyn在ROSC即刻明显降低(P<0.05),而RI、DO_2、VO_2、O_2ER、Raw、EVLWI、PVPI、PaCO_2和LAC在ROSC即刻则显著升高(P<0.05),各指标不论升高或降低均随时间延长而恢复;与盐水组比较,参附组在ROSC后的各个时间点,OI、Cdyn、DO_2、VO_2和O2ER显著高于盐水组(P<0.05,P<0.01),而RI、Raw、EVLWI、PVPI、PaCO_2和LAC则低于盐水组(P<0.05,P<0.01)。与盐水组比较,参附组Na^+-K^+-ATP酶、Ca^(2+)-ATP酶、SOD水平、IFN-γ水平、IFN-γ/IL-4值及Bcl-2浓度升高,而M
