丹参多酚酸盐治疗感染性休克凝血功能异常的临床研究  

A clinical research of Salvianolate for treatment of coagulant function abnormality in patients with septic shock

作　　者：唐召力[1] 唐夏楠 曾广志[1] 唐海莲[1] 曾慧志 Tang Zhaoli Tang Xianan Zeng Guangzhi Tang Hailian Zeng Huizhi(Department of Critical Care Medicine, Liuzhou Municipal Liutie Central Hospital, Liuzhou 545007, Guanxi, China Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, Hubei, China)

机构地区：[1]柳州市柳铁中心医院重症医学科,广西柳州545007 [2]华中科技大学同济医院,湖北武汉430030

出　　处：《中国中西医结合急救杂志》2017年第1期14-16,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：广西柳州市科研技术开发计划项目（2008031405）

摘　　要：目的探讨丹参多酚酸盐对感染性休克患者凝血功能异常的临床疗效。方法选择柳州市柳铁中心医院重症医学科重症加强治疗病房（ICU）2007年1月至2016年6月收治的152例休克患者，按计算机产生的随机数字分对照组（67例）和丹参多酚酸盐组（85例）。对照组给予西医常规治疗，丹参多酚酸盐组在常规治疗基础上静脉滴注（静滴）丹参多酚酸盐200mg，每日1次，连续10d。于入院1、3、7、10d测定、D-二聚体、血小板计数（PLT）水平；观察两组入院10d弥散性血管内凝血（DIE）发生率和病死率。结果丹参多酚酸盐组人院3、7、10dD-二聚体水平明显低于对照组（mg／L：入院3d为9．14±2．25比18．42±3．15，入院7d为6．71±1．49比14．57±1．81，入院10d为1．01±0．20比4．79±0．81，均P〈0．01）。两组入院1dPLT水平即开始降低，入院3d、7d明显降低，入院10d升高，入院3、7、10d丹参多酚酸盐组PLT水平明显高于对照组（×10^9／L：入院3d为67．24±6．35比40．97±6．51，入院7d为67．24±6．35比32．06±5．13，入院10d为90．18±11．42比59．04±6．57，均P〈0．01）。丹参多酚酸盐组DIE发生率和病死率均明显低于对照组[DIC发生率12．94％（11／85）和38．8％（26／67），病死率：5．88％（5／85）和29．85％（20／67），均P〈0．01]。结论休克患者多存在凝血功能异常，PLT降低主要是由于微小血栓形成消耗大量PLT所致。早期使用丹参多酚酸盐能抑制血栓形成，阻断PLT消耗，对纠正凝血功能异常有一定效果。Objective To explore the clinical effect of Salvianolate for treatment of coagulant function abnormality in patients with septic shock. Methods One hundred and fifty-two septic shock patients admitted to Intensive Care Unit （ICU） of Department of Critical Care Medicine, Liuzhou Municipal Liutie Central Hospital from January 2007 to June 2016 were enrolled, and they were divided into a control group （67 cases） and a Salvianolate group （85 cases） by random number table. In the control group, conventional western medicine treatment was given, while in Salvianolate group, besides conventional treatment, additionally, Salvianolate 200 mg intravenous drip was applied daily for consecutive 10 days. The levels of D-direct and platelet count （PLT） were examined on the 1st, 3rd, 7th, 10th day after admission; disseminated intravascular coagulation （DIC） incidence and mortality were observed in 10 days after admission in the two groups. Results The levels of D-direct were significantly lower in the Salvianolate group than those of the control group on 3, 7, 10 days after admission （mg/L： 3 days was 9.14 ± 2.25 vs. 18.42 ± 3.15, 7 days was 6.71 ± 1.49 vs. 14.57 ± 1.81, 10 days was 1.01 ± 0.20 vs. 4.79 ± 0.81, all P 〈 0.01）. In both groups, on the first day after admission the level of PLT began to decrease, on the 3th, 7th day the levels were lowered significantly, and on the 10th day, the level of PLT was elevated; in the Salvianolate group, the levels of PLT were obviously higher on the 3rd, 7th, 10th day after admission than those of the control group [PLT （× 10^9/L） 3 days after admission： 67.05 ± 7.76 vs. 40.97 ± 6.51, 7 days： 67.24 ± 6.35 vs. 32.06 ± 5.13, 10 days： 90.18 ± 11.42 vs. 59.04 ± 6.57, all P 〈 0.01]. The DIC incidence and mortality were significantly lower in the Salvianolate group than those of the control group [DIC incidence： 12.94% （11/85） vs. 38.8% （26/67）, mortality： 5.88% （5/85） vs. 29.85% （20/67）, both P 〈 0.01]. Conclusions C

关 键 词：丹参多酚酸盐 休克 感染性 凝血功能异常 弥散性血管内凝血 

分 类 号：R979.9[医药卫生—药品]