血必净注射液对重症创伤患者炎症反应的抑制作用  

Suppression of Xuebijing injection （血必净注射液） on inflammatory response in patients with severe trauma

作　　者：王静[1] 高燕[1] 赵雪生[1] 崔岩[1] 滕玥[1] 

机构地区：[1]沈阳军区总医院急诊科,辽宁沈阳110016

出　　处：《中国中西医结合急救杂志》2011年第4期203-205,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：辽宁省自然科学基金资助项目（20082069）

摘　　要：目的探讨早期应用血必净注射液对重症创伤患者炎症反应的影响和临床应用价值。方法采用前瞻性研究方法，选择2009年10月至2010年11月急诊重症监护病房（EIcu）收治的重症创伤患者93例，按随机原则分为治疗组（45例）和对照组（48例）；两组患者一般处理及对症治疗方法相同，治疗组加用血必净注射液100ml静脉滴注，12h1次，连用7d；观察患者病死率、EICU住院时间、体温、白细胞计数（WBC）、氧合指数（PaO2／FiO2）、外周血管阻力指数（SVRI）、血乳酸的变化；采酶联免疫吸附法（ELISA）检测血中肿瘤坏死因子-α（TNF—α）含量的变化。结果治疗组和对照组治疗后病死率和EICU住院时间比较差异均无统计学意义[病死率：30．8％比32．6％；EICU住院时间（d）：9．5±2．5比11．3±2．1，均P〉0．053；体温、WBC、血乳酸、TNF—α均较治疗前明显降低，PaO2／FiO2、SVRI均较治疗前明显升高，且治疗组降低和升高程度较对照组更显著[体温（℃）：37．4v10．5比38．5±11．6；WBC（×10^9／L）：10．6±5．5比13．5±6．7；乳酸（mmol／L）：1．28±0．44比1．54±0．58；TNF—α（ng／L）：18．1±5．8比27．9±9．5；PaO2／FiO2（mmHg，1mmHg=0．133kPa）：286．3±55．3比229．3±55．2；SVRI（kPa·s·L^-1：211．7±28．9比198．0±25．8，P〈0．05或P〈0．01]。结论早期应用血必净注射液能有效抑制重症创伤患者的炎症反应，改善血流动力学状况，纠正脓毒性休克症状，减少EICU住院时间和病死率。Objective To explore the effects and early clinical application value of Xuebijing injection （血必净注射液） on the inflammatory reaction of patients with severe trauma. Methods Ninety-three hospitalized cases with severe trauma in the Emergency Intensive Care Unit （EICU） of our hospital from October 2009 to November 2010 were selected and retrospectively analyzed. They were randomly divided into treatment group （45 cases） and control group （48 cases）. Routine treatment was given to both groups, and additionally Xuebijing injection 100 ml intravenous drip was given to the treatment group, once every 12 hours for consecutive 7 days. The mortality, the length of EICU stay, body temperature, white blood cell count （WBC）, oxygenation index （PaOJFiO2）, systemic vascular resistance index （SVRI）, blood lactic acid （Lac） were observed and the content of tumor necrosis factor-α （TNF-α） was measured by enzyme linked immunosorbent assay （ELSIA）in the two groups. Results There were no significant differences in mortality and the length of EICU stay between the two groups [mortality： 30.8% vs. 32.6% ; the length of EICU stay （day）： 9.5±2.5 vs. 11.3±2.1, P〉0. 05]. After treatment, the body temperature, WBC, blood Lae and TNF-α were reduced significantly, while PaO2/FiO2 and SRVI were elevated obviously in comparison with those before the treatment （P〈0.01 or P〈0. 05）, and the degrees of reduction and elevation were more significant in treatment groups than those in control groups [temperature （℃）： 37.4±10. 5 vs. 38.5± 11.6; WBC （×10^9/L）： 10. 6±5.5 vs. 13.5±6.7, Lac （mmol/L）： 1.28±0.44 vs. 1.54±0. 58, TNF-α （ng/L）： 18.1±5.8 vs. 27.9±9.5, PaO2/FiO2（mm Hg, 1 mm Hg=0.133 kPa）.. 286.3±55.3 vs. 229.3±55.2, SVRI （kPa· s·L^-1） ： 211.7±28. 9 vs. 198. 0±25.8, P〈0.05 or P〈0.01]. Conclusion Early application of Xuebijing injection can significantly reduce the inflammatory response in patients with severe trauma, imp

关 键 词：重症创伤 炎症 中药 血必净注射液 中西医结合疗法 

分 类 号：R285.6[医药卫生—中药学] R364.5[医药卫生—中医学]