黄芪注射液联合美罗培南治疗重症感染的效果观察及对血T淋巴细胞亚群和炎性因子影响  

Clinical effect of Astragalus injection combined with meropenem in the treatment of severe infection patients and its influence on T lymphocyte subsets and inflammatory factors in peripheral blood

作　　者：应伟国 高庆林 李琢 Ying Weiguo;Gao Qinglin;Li Zhuo(Department of Critical Care Medicine,Yiwu Fuyuan Private Hospital,Yiwu,Zhejiang 322000,China)

机构地区：[1]义乌復元私立医院重症医学科,浙江省322000

出　　处：《中国基层医药》2020年第2期205-208,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨黄芪注射液联合美罗培南治疗重症感染的效果及对外周血T淋巴细胞亚群和炎性因子的影响。方法选择义乌復元私立医院2016年1月至2018年12月收治的重症感染患者80例,依据单盲随机数字表法分为观察组(n=40)与对照组(n=40)。观察组采用黄芪注射液联合美罗培南治疗,对照组采用美罗培南治疗。两组疗程均为10 d。比较两组治疗疗效,治疗前后体温、心率和呼吸频率变化,外周血T淋巴细胞亚群、炎性因子变化及细菌培养转阴的时间。结果观察组总有效率(92.50%)高于对照组(70.00%)(χ^2=6.646,P<0.05);观察组治疗后CD3+(62.38±4.51)%、CD4+(40.63±2.15)%和CD4+/CD8+(1.63±0.18),高于对照组的(57.27±3.19)%、(35.47±1.93)%和(1.30±0.21)(t=5.850、11.296、7.546,均P<0.05);观察组治疗后C反应蛋白(28.79±8.74)mg/L、降钙素原(0.56±0.12)μg/L和肿瘤坏死因子α(157.93±20.47)pg/mL,均低于对照组的(43.71±12.67)mg/L、(1.10±0.23)μg/L和(247.16±34.64)pg/mL(t=13.640、13.165、14.026,均P<0.05);观察组细菌培养转阴时间(4.36±1.29)d,短于对照组的(7.43±1.57)d(t=9.493,P<0.05)。结论黄芪注射液联合美罗培南治疗重症感染患者临床效果显著,可提高患者细胞免疫功能及减轻炎性反应。Objective To investigate the clinical effect of Astragalus injection combined with meropenem in the treatment of severe infection patients and its influence on T lymphocyte subsets and inflammatory factors in peripheral blood.Methods From January 2016 to December 2018,80 patients with severe infections in Yiwu Fuyuan Private Hospital were selected and divided into observation group(n=40)and control group(n=40)according to single blind random table method.The observation group was treated with Astragalus injection combined with meropenem,while the control group was treated with meropenem.Both two groups were treated for 10 days.The therapeutic effects,changes of body temperature,heart rate and respiratory rate,changes of T lymphocyte subsets and inflammatory factors in peripheral blood,and negative time of bacterial culture before and after treatment were compared between the two groups.Results The total effective rate of the observation group(92.50%)was higher than that of the control group(70.00%)(χ^2=6.646,P<0.05).After treatment,the levels of CD3+[(62.38±4.51)%],CD4+[(40.63±2.15)%]and CD4+/CD8+(1.63±0.18)in the observation group were higher than those in the control group[(57.27±3.19)%,(35.47±1.93)%and(1.30±0.21)](t=5.850,11.296,7.546,all P<0.05).After treatment,the levels of CRP[(28.79±8.74)mg/L],PCT[(0.56±0.12)g/L]and TNF-α[(157.93±20.47)pg/mL]in the observation group were lower than those in the control group[(43.71±12.67)mg/L,(1.10±0.23)g/L and(247.16±34.64)pg/mL](t=13.640,13.165,14.026,all P<0.05).The negative turning time of bacterial culture in the observation group[(4.36±1.29)d]was shorter than that in the control group[(7.43±1.57)d](t=9.493,P<0.05).Conclusion Astragalus membranaceus injection combined with meropenem has significant clinical effect in the treatment of patients with severe infections.It can improve cellular immune function and reduce inflammatory reaction,which is worthy of clinical reference.

关 键 词：细菌感染 T淋巴细胞亚群 降钙素 肿瘤坏死因子-α C反应蛋白质 黄芪注射液 美罗培南 

分 类 号：R45[医药卫生—治疗学]