降钙素原在脓毒症患者中的动态变化及中药干预的影响  

Dynamic changes of serum procalcitonin in patients with sepsis and the intervention effect of Chinese herbal medicine on the changes

作　　者：奚晶晶[1] 王红[2] 杨钧[3] 

机构地区：[1]北京大学第三医院危重医学科,北京100083 [2]首都医科大学附属北京友谊医院感染暨急救医学内科,北京100050 [3]武警总医院重症监护科,北京100039

出　　处：《中国中西医结合急救杂志》2007年第6期327-329,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：北京市自然科学基金资助项目(7052026)

摘　　要：目的：观察中药复方清热颗粒对脓毒症患者血清降钙素原（PCT）的干预作用。方法：选择46例脓毒症患者,按随机原则分为中药复方清热颗粒加西药治疗组（22例）和单纯西药治疗组（24例）两组。采用发光免疫分析法（ILMA）测定两组患者治疗前后血清PCT水平。结果：脓毒症患者病初即出现血清PCT显著增高[（2.42±3.13）μg/L,正常参考值为0.05μg/L];按急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）分值分为高分组（11～17分）和低分组（7～10分）,APACHEⅡ高分组PCT水平显著高于APACHEⅡ低分组[（3.68±4.18）μg/L比（1.63±1.88）μg/L,P〈0.05];经治疗7 d后PCT呈下降趋势,且中药复方清热颗粒加西药治疗组PCT下降幅度显著大于单纯西药治疗组[治疗前后差值（2.53±2.67）μg/L比（0.06±1.85）μg/L,P〈0.01]。结论：PCT能反映脓毒症的严重程度,随病情好转PCT水平下降;中药复方清热颗粒使脓毒症患者PCT水平显著下降,提示其可加强抗感染作用。Objective： To observe the intervention effect of Chinese herbal medicine,Compound Qingre granule（中药复方清热颗粒）,on serum procalcitonin（PCT） in patients with sepsis.Methods： Forty-six patients with sepsis were selected and randomly divided into two groups： Compound Qingre granule group treated with the granules and the western medicine（group A,n=22） and the control group treated with only western medicine（group B,n=24）.Serum PCT in the patients of the two groups was measured before and after treatment by using immunoluminometer assay（ILMA）.Results： The level of PCT increased markedly at the early stage of sepsis（（2.42±3.13） μg/L,the normal reference value being 0.05 μg/L）.According to acute physiology and chronic health evaluationⅡ（APACHEⅡ） scores,there were two groups： high score（11-17 score） and low score（7-10 score）.The level of PCT in group with APACHEⅡ high score was significantly higher than that in group with APACHEⅡ low score（（3.68±4.18） μg/L vs.（1.60±1.88） μg/L,P〈0.05）.After 7 days of treatment,the level of PCT decreased with the condition improved.Group A had a significant decrease in PCT after treatment compared with that before treatment,whereas group B had a little change in PCT（changes before and after treatment（2.53±2.67） μg/L vs.（0.06±1.85） μg/L,P〈0.01）.Conclusion： PCT can reflect the severity of sepsis and the level of PCT decreased in accord with the improvement of the disease situation after treatment.The serum PCT decreased significantly after treatment in Compound Qingre granule group.It is suggested that Compound Qingre granule enhance anti-infection.

关 键 词：降钙素原 脓毒症 中药 复方清热颗粒 

分 类 号：R459.7[医药卫生—急诊医学] R278[医药卫生—治疗学]