血必净对严重脓毒症患者内皮功能及血清炎症因子的影响  

Effects of Xuebijing on endothelial functions and serum inflammatory factors in patients with severe sepsis

作　　者：朱永[1] 李娜[1] 何振扬[1] 陈民科[1] 王华杰[1] 麦叶[1] 

机构地区：[1]海南省人民医院重症医学科,海南海口570311

出　　处：《中国临床研究》2016年第6期746-748,752,共4页Chinese Journal of Clinical Research

基　　金：2014年海南省自然科学基金资助项目(814322)

摘　　要：目的探讨血必净在严重脓毒症患者治疗中的效果以及对内皮功能和血清炎症因子的影响。方法选取2014年9月至2015年11月收治的58例严重脓毒症患者为研究对象,采用随机数字表法分为观察组和对照组各29例。对照组行常规治疗,观察组在对照组基础上加用血必净治疗。比较两组患者治疗前、治疗3、7 d后器官衰竭评分,APACHⅡ评分及血清白介素(IL)-6、IL-10、肿瘤坏死因子(TNF)-α、内皮特异分子1(ESM-1)、可溶性血栓调节蛋白(sTM)、可溶性E选择素的水平及不良反应率。结果经治疗,两组患者的器官衰竭评分和APACHⅡ评分依治疗前、治疗3 d、7 d顺序,呈逐次下降(P均<0.01),且观察组治疗后显著优于对照组(P均<0.01)。两组患者治疗前后IL-10水平无明显变化(P均>0.05);两组患者IL-6、TNF-α水平依治疗前、治疗3 d、7 d顺序,呈逐次下降(P均<0.01),且观察组治疗后显著优于对照组(P均<0.01);两组患者s TM、可溶性E选择素及ESM-1水平依治疗前、治疗3 d、7 d顺序,呈逐次下降(P均<0.01),且观察组治疗后显著优于对照组(P均<0.01)。观察组不良反应率(6.9%)与对照组(3.5%)相比差异无统计学意义(P>0.05)。结论应用血必净治疗严重脓毒症可显著抑制炎症因子和改善内皮细胞功能,有利于改善患者预后。Objective To explore the efficacy of Xuebijing for the treatment of severe sepsis and the influence on endothelial functions and serum inflammatory factors of patients. Methods A total of 58 patients with severe sepsis treated from September 2014 to November 2015 were selected as the research objects and divided into observation group and control group by random digital table method（ n = 29 each）. The routine treatment was given in control group,and the Xuebijing was given in observation group based on routine treatment. The organ failure score,Acute Physiology and Chronic Health Evaluation II（ APACHE II） score,serum levels of interleukin（ IL）-6,IL-10,tumor necrosis factor-alpha（ TNF-α）,endothelial specific molecule-1（ ESM-1）,soluble regulatory protein（ s TM）,soluble E-selectin（ s ES） before treatment and 3-,7-day after treatment and the adverse reaction rate were observed. Results The organ failure score and APACH-II score showed a gradual decline in the order of pre-treatment and 3-,7-day after treatment in the two groups（ all P 0. 01）,and the scores after treatment in observation group were significantly lower than those in control group（ all P 0. 01）. The levels of IL-6,TNF-α,s TM,s ES and ESM-1 gradually decreased in the order of pre- treatment,3- and 7-day after treatment in the two groups（ all P 0. 01）,and their levels after treatment in observation group were significantly lower than those in control group（ all P 0. 01）. There were no significant changes in the levels of IL-10 before and after treatment in two groups（ all P 0. 01）. There was no statistical difference in adverse reaction rates between two groups（ P 0. 05）. Conclusion Xuebijing can obviously inhibit inflammatory factors and improve endothelial cell functions for the treatment of severe sepsis and is helpful for improving the prognosis of patients with severe sepsis.

关 键 词：血必净 脓毒症 器官衰竭评分 急性生理和慢性健康状况评分系统Ⅱ 内皮功能 血清炎症因子 

分 类 号：R631[医药卫生—外科学]