血必净对感染性休克患者血流动力学及炎性因子的影响  

Influence of Xuebijing injection on inflammatory cytokines and hemodynamics in patients with septic shock patients

作　　者：王明强[1] 张思森[1] 

机构地区：[1]南方医科大学附属郑州人民医院重症医学科,郑州450000

出　　处：《临床急诊杂志》2015年第2期126-130,共5页Journal of Clinical Emergency

摘　　要：目的:观察血必净对感染性休克患者血流动力学及炎性因子的影响。方法:64例感染性休克患者随机分为2组:对照组32例患者在常规治疗的基础上给予参附注射液治疗,观察组32例患者在对照组治疗基础上给予血必净注射液,比较2组患者治疗前后的血流动力学(HR、CI、MAP、CVP、PAWP、尿量、SpO2、SvO2、PaO2/FiO2)、炎性因子指标(LA、CRP、PCT)及疗效指标(APACHEⅡ评分、SOFA评分)。结果:治疗72h后,观察组总有效率高于对照组(χ2=4.266 6,P<0.05);2组患者的血流变、炎症因子及疗效指标均较治疗前显著改善(P<0.01),而观察组的改善更显著(P<0.01或P<0.05);观察组患者的复苏液体总量、多巴胺、去甲肾上腺素、多巴酚丁胺、胰岛素、氢化可的松使用剂量均少于对照组(P<0.01或P<0.05),2组患者的病死率差异无统计学意义。结论:血必净可用于感染性休克,其作用机制可能为改善血流动力学异常,抑制炎症反应。Objective：To observe the influence of Xuebijing injection on inflammatory cytokines and hemodynamics in patients with septic shock.Method：64patients with septic shock were randomly divided into two groups.The control group were treated with Shenfu injection on the basis of routine treatment.The observation group were treated with Xuebijing injection on the basis of the control group.To compare the index of hemodynamic（HR、CI、MAP、CVP、PAWP、urine volume、SpO2、SvO2、PaO2/FiO2）、inflammatory factor（LA、CRP、PCT）and therapeutic effect index（APACHE Ⅱ score、SOFA score）between two groups before and after treatment.Result：72hours after treatment,the total efficiency of the observation group was higher than that of the control group（χ2=4.266 6,P〈0.05）.Blood rheology,inflammatory factors and therapeutic effect index in patients of two groups were significantly improved after treatment than those before treatment（P〈0.01）.They were improved more obviously in the observation group（P〈0.01 or P〈0.05）.The total amount of liquid resuscitation,dopamine,norepinephrine,dobutamine,insulin,hydrocortisone dosage of the observation group were lower than that of the control group（P〈0.01 or P〈0.05）,but the mortality rate has no significant difference between two groups.Conclusion：Xuebijing injection in the treatment of septic shock is safe and effective.Ameliorating of hemodynamic abnormalities and inhibiting the inflammatory reaction may be its mechanism of action.

关 键 词：血必净注射液 参附注射液 感染性休克 血流动力学 炎性因子 

分 类 号：R631[医药卫生—外科学]