参附注射液联合糖皮质激素对脓毒血症患者PCT、NT-proBNP及炎症因子的影响  

Effects of Shenfu Injection Combined with Glucocorticoid on PCT,NT-proBNP and Inflammatory Factors in Patients with Sepsis

作　　者：王翔 李建国[2] 李志峰[2] 吕明珠 张志敏[1] 苗丽霞[1] 宋亚君[1] Wang Xiang;Li Jianguo;Li Zhifeng(Dongfeng General Hospital Affiliated to Hubei Medical College,Hubei,Shiyan 442000,China)

机构地区：[1]湖北医药学院附属东风总医院,湖北十堰442000 [2]武汉大学中南医院,湖北武汉430077

出　　处：《中国中医急症》2019年第6期954-957,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(81571946)

摘　　要：目的观察参附注射液联合糖皮质激素对脓毒血症患者降钙素原(PCT)、N末端B型利钠肽原(NT-proBNP)及炎症因子的影响。方法患者90例按随机数字表法分为两组,在常规治疗基础上,对照组接受糖皮质激素治疗,观察组联合应用参附注射液治疗。比较两组炎症因子、NT-proBNP及PCT水平变化,并进行疗效评价及不良反应发生情况分析。结果治疗后两组肿瘤坏死因子-α(TNF-α)、白细胞介素-18(IL-18)、白细胞介素-10(IL-10)水平均明显降低(P<0.05),且以观察组降低更为显著(P<0.05)。治疗后两组PCT和NT-proBNP均低于治疗前(P<0.05);且观察组低于对照组(P<0.05)。治疗后,两组单核细胞表面人类白细胞抗原DR位点(HLA-DR)水平比治疗前提升(P<0.05),且观察组高于对照组(P<0.05)。对照组总有效率为82.22%,明显低于观察组的95.56%(P<0.05)。对照组出现疑似药物不良反应3例(6.67%),观察组出现疑似药物不良反应2例(4.44%),两组差异无统计学意义(P>0.05)。结论参附注射液联合糖皮质激素辅助治疗脓毒血症疗效显著,其作用机制可能与减轻炎症反应,提升免疫力,同时降低NT-proBNP及PCT水平,提升HLA-DR水平有关。Objective:To study the effects of Shenfu Injection combined with glucocorticoid on PCT,NT-proBNP and inflammatory factors in patients with sepsis. Methods:90 patients were randomly divided into two groups,45 in each. On the basis of conventional treatment,the control group received glucocorticoid therapy,the observation group Shenfu Injection. The changes of inflammatory factors,NT-proBNP and PCT levels were compared between groups,and the efficacy evaluation and adverse reaction were analyzed. Results:After treatment,the levels of TNF-α,IL-18 and IL-10 were significantly decreased(P < 0.05),and the decrease was significant in the observation group(P<0.05). After treatment,PCT and NT-proBNP were lower than those before treatment(P < 0.05);and the observation group was lower than the control group(P < 0.05). Before treatment,there was no significant difference in HLA-DR levels between groups(P > 0.05). After treatment,HLA-DR levels in the two groups were higher than those before treatment(P < 0.05),and the observation group was higher than the control group(P < 0.05). The effective rate of the control group was 82.22%,which was significantly lower than that of the observation group(95.56%)(P < 0.05). There were 3 cases(6.67%) of suspected drug adverse reactions in the control group,2 cases(4.44%) in the observation group,with no significant difference(P > 0.05). Conclusion:Shenfu Injection combined with glucocorticoid has a significant effect on sepsis. Its mechanism may be related to alleviating inflammation,enhancing immunity,lowering NT-proBNP and PCT levels,and raising the level of human leukocyte antigen DR site on monocyte surface.

关 键 词：脓毒血症 参附注射液 糖皮质激素 炎症 N末端B型利钠肽原 降钙素原 

分 类 号：R631[医药卫生—外科学]