目的:观察连续肾替代治疗(CRRT)加用不同剂量血必净对脓毒症合并急性肾损伤(AKI)患者的影响及安全性。方法:选取2012年6月-2015年8月我院ICU的脓毒症合并AKI患者104例。按照随机数字表法将其分为小、中、大剂量组和对照组,各26例。4组...目的:观察连续肾替代治疗(CRRT)加用不同剂量血必净对脓毒症合并急性肾损伤(AKI)患者的影响及安全性。方法:选取2012年6月-2015年8月我院ICU的脓毒症合并AKI患者104例。按照随机数字表法将其分为小、中、大剂量组和对照组,各26例。4组患者均给予基础治疗;小剂量组患者给予血必净注射液50 m L加入0.9%氯化钠注射液(NS)100 m L中,ivgtt,bid;中剂量组患者给予血必净注射液100 m L加入NS 100 m L中,ivgtt,bid;大剂量组患者给予血必净注射液100 m L加入NS 100 m L中,ivgtt,qid。4组患者均治疗1周。观察4组患者治疗前后血清白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、和超敏C反应蛋白(hs-CRP)等炎症因子水平,血尿素氮(BUN)、血肌酐(SCr)和胱抑素(Cys C)等肾功能指标水平,凝血酶原时间(PT)、部分活化凝血活酶时间(APTT)和纤维蛋白原(Fib)等凝血功能指标水平,急性生理与慢性健康状况评分系统Ⅱ(APACHEⅡ)、多器官功能障碍评分系统(Marshall)评分,并记录治疗过程中不良反应发生情况。结果:脱落9例后,本研究最终纳入统计的合格病例数95例,小、中、大剂量组和对照组分别为23、24、25、23例。治疗前,4组患者上述指标比较,差异均无统计学意义(P>0.05)。治疗后,4组患者血清IL-6、TNF-α、CRP、PT、APTT水平和APACEⅡ及Marshall评分均明显降低/缩短,血清BUN、SCr、Cys C、Fib水平均明显升高,小、中、大剂量组患者上述指标改善均明显优于对照组,大剂量组明显优于小、中剂量组,差异均有统计学意义(P<0.05)。4组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:CRRT加用大剂量血必净可显著抑制脓毒症合并AKI患者的炎症反应,改善肾功能和凝血功能,且不增加不良反应发生风险。展开更多
Objective: To observe the effects of Xuebijing Injection (血必净注射液) in patients with severe pneumonia, and to explore the mechanism. Methods: Eighty cases of severe pneumonia are randomly assigned to the Xuebijing...Objective: To observe the effects of Xuebijing Injection (血必净注射液) in patients with severe pneumonia, and to explore the mechanism. Methods: Eighty cases of severe pneumonia are randomly assigned to the Xuebijing treatment (forty cases) and the control group (forty cases), with the same routine therapy provided in both groups. Clinical effective rates, inflammatory factors and organ function were observed in both groups. Results: The effective rate was higher in Xuebijing group than that of the control group (80.0% vs. 67.5%, P<0.05). As compared with the control group, the LDH, α1-AG, α1-AT levels and the peak body temperature decreased markedly with the Xuebijing treatment going, and the secretion of TNF-α, IL-6, IL-8 was suppressed in Xuebijing group; but no significant difference was found in leptin level. Conclusion: Xuebijing Injection may show a protective effect in patients with severe pneumonia. The mechanism is possibly with the decreased secretion of TNF-α, IL-6, and IL-8.展开更多
文摘目的:观察连续肾替代治疗(CRRT)加用不同剂量血必净对脓毒症合并急性肾损伤(AKI)患者的影响及安全性。方法:选取2012年6月-2015年8月我院ICU的脓毒症合并AKI患者104例。按照随机数字表法将其分为小、中、大剂量组和对照组,各26例。4组患者均给予基础治疗;小剂量组患者给予血必净注射液50 m L加入0.9%氯化钠注射液(NS)100 m L中,ivgtt,bid;中剂量组患者给予血必净注射液100 m L加入NS 100 m L中,ivgtt,bid;大剂量组患者给予血必净注射液100 m L加入NS 100 m L中,ivgtt,qid。4组患者均治疗1周。观察4组患者治疗前后血清白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、和超敏C反应蛋白(hs-CRP)等炎症因子水平,血尿素氮(BUN)、血肌酐(SCr)和胱抑素(Cys C)等肾功能指标水平,凝血酶原时间(PT)、部分活化凝血活酶时间(APTT)和纤维蛋白原(Fib)等凝血功能指标水平,急性生理与慢性健康状况评分系统Ⅱ(APACHEⅡ)、多器官功能障碍评分系统(Marshall)评分,并记录治疗过程中不良反应发生情况。结果:脱落9例后,本研究最终纳入统计的合格病例数95例,小、中、大剂量组和对照组分别为23、24、25、23例。治疗前,4组患者上述指标比较,差异均无统计学意义(P>0.05)。治疗后,4组患者血清IL-6、TNF-α、CRP、PT、APTT水平和APACEⅡ及Marshall评分均明显降低/缩短,血清BUN、SCr、Cys C、Fib水平均明显升高,小、中、大剂量组患者上述指标改善均明显优于对照组,大剂量组明显优于小、中剂量组,差异均有统计学意义(P<0.05)。4组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:CRRT加用大剂量血必净可显著抑制脓毒症合并AKI患者的炎症反应,改善肾功能和凝血功能,且不增加不良反应发生风险。
文摘Objective: To observe the effects of Xuebijing Injection (血必净注射液) in patients with severe pneumonia, and to explore the mechanism. Methods: Eighty cases of severe pneumonia are randomly assigned to the Xuebijing treatment (forty cases) and the control group (forty cases), with the same routine therapy provided in both groups. Clinical effective rates, inflammatory factors and organ function were observed in both groups. Results: The effective rate was higher in Xuebijing group than that of the control group (80.0% vs. 67.5%, P<0.05). As compared with the control group, the LDH, α1-AG, α1-AT levels and the peak body temperature decreased markedly with the Xuebijing treatment going, and the secretion of TNF-α, IL-6, IL-8 was suppressed in Xuebijing group; but no significant difference was found in leptin level. Conclusion: Xuebijing Injection may show a protective effect in patients with severe pneumonia. The mechanism is possibly with the decreased secretion of TNF-α, IL-6, and IL-8.
