血必净对脓毒症患者乳酸清除率、乳酸面积的影响及转归分析  

Effect of Xuebijing injection on lactate clearance rate and lactate area in patients with sepsis and the analysis of outcome

作　　者：王玉珍[1] 李勇[2] 白奎[1] 高海波[1] 庄九杰 WANG Yu-zhen;LI Yong;BAI Kui;GAO Hai-bo;ZHUANG Jiu-jie(Department of Critical Care Medicine,First Affiliated Hospital of Henan University,Kaifeng 475001,China;Department of Traditional Chinese Medicine,First Affiliated Hospital of Henan University,Kaifeng 475001,China)

机构地区：[1]河南大学第一附属医院重症医学科,河南开封475001 [2]河南大学第一附属医院中医科,河南开封475001

出　　处：《实用药物与临床》2019年第4期397-400,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的观察血必净对脓毒症患者乳酸清除率、乳酸面积的影响及临床转归。方法选取我院2015年2月至2018年2月收治的90例脓毒症患者,按随机数表法分为观察组与对照组,各45例。两组均予常规治疗,包括维持电解质平衡、静脉营养、液体复苏、抗生素抗感染、控制血糖、血管活性药物。观察组在常规治疗基础上应用血必净注射液,对照组则在相同时间予等量生理盐水。均连用1周。比较两组治疗前后的乳酸清除率、乳酸面积、凝血酶原时间(PT)异常率、纤维蛋白原(FIB)异常率、血小板(PLT)异常率、APACHE评分、SOFA评分及28 d、90 d死亡率。结果治疗前,两组的乳酸清除率、乳酸面积比较差异无统计学意义(P>0.05);治疗后,两组的乳酸清除率均升高,乳酸面积降低,差异有统计学意义(P<0.05)。治疗后,观察组的乳酸清除率为91.65%±8.21%,高于对照组的85.67%±7.79%,乳酸面积为41.02±8.96,低于对照组的50.32±9.75,差异有统计学意义(P<0.05)。治疗前,两组PT异常率、FIB异常率、PLT异常率、APACHE评分、SOFA评分比较差异无统计学意义(P>0.05);治疗后,两组上述指标水平均降低(P<0.05),且观察组低于对照组,差异有统计学意义(P<0.05)。两组28 d、90 d死亡率比较差异无统计学意义(P>0.05)。结论血必净注射液具有改善凝血、器官保护的作用,与常规综合治疗相比可能使临床转归受益。Objective To observe the effect of Xuebijing injection on lactate clearance rate and lactate area in patients with sepsis and its clinical outcome.Methods A total of 90 patients with sepsis admitted to our hospital from February 2015 to February 2018 were randomly divided into observation group and control group,with 45 cases in each group.Both groups received routine treatment,including maintenance of electrolyte balance,intravenous nutrition,fluid resuscitation,antibiotics,anti-infection,glycemic control,and vasoactive drugs.In observation group,Xuebijing injection was applied on the basis of conventional treatment,and control group was given an equal amount of NS at the same time.All the treatment lasted for 1 week.The lactate clearance rate,lactate area,prothrombin time(PT)abnormal rate,fibrinogen(FIB)abnormal rate,platelet(PLT)abnormal rate,APACHE score,SOFA score,28 d mortality rate and 90 d mortality were compared between the two groups.Results There was no significant difference in lactate clearance rate or lactate area between the two groups before treatment(P>0.05).After treatment,the lactate clearance rate of the two groups was increased(P<0.05),while the lactate area was decreased(P<0.05);the lactate clearance rate of observation group was higher than that of control group(91.65%± 8.21% vs.85.67%± 7.79%),while the lactate area was less than that of control group(41.02 ± 8.96 vs.50.32 ± 9.75,P<0.05).There was no significant difference in PT abnormal rate,FIB abnormal rate,PLT abnormal rate,APACHE score or SOFA score between the two groups before treatment(P>0.05).After treatment,the PT abnormal rate,FIB abnormal rate,PLT abnormal rate,APACHE score and SOFA score were decreased(P<0.05);the levels of the above indexes in observation group were lower than those in control group(P<0.05).There was no significant difference in 28 d or 90 d mortality between the two groups(P>0.05).Conclusion Xuebijing injection can improve the effect of blood coagulation and organ protection,which may benefit clinical out

关 键 词：血必净注射液 脓毒症 乳酸 凝血 转归 

分 类 号：R459.7[医药卫生—急诊医学]