不同剂量血必净注射液治疗重型新型冠状病毒肺炎的疗效观察  

Therapeutic effect observation on different doses of Xuebijing Injection in treatment of severe corona virus disease 2019

作　　者：李硕[1] 陆伟 赵学群[3] 彭民[4] 黄少祥[5] 赖雁平[6] 史东升[7] Li Shuo;Lu Wei;Zhao Xuequn;Peng Min;Huang Shaoxiang;Lai Yanping;Shi Dongsheng(Department of Respiratory and Critical Care Medicine,General Hospital of Tianjin Medical University,Tianjin 300050,China;Tianjin Cancer Hospital,Tianjin 300060,China;Department of Infection,the First Central Hospital of Tianjin,Tianjin 300192,China;Department of Critical Care Medicine,General Hospital of Tianjin Medical University,Tianjin 300050,China;Department of Respiratory,the Fifth Central Hospital of Tianjin,Tianjin 300450,China;Department of Respiratory,the Second Hospital of Tianjin Medical University,Tianjin 300211,China;Department of Respiratory,Tianjin Chest Hospital,Tianjin 300051,China)

机构地区：[1]天津医科大学总医院呼吸与危重症医学科,天津300050 [2]天津市肿瘤医院,天津300060 [3]天津市第一中心医院感染科,天津300192 [4]天津医科大学总医院危重症医学科,天津300050 [5]天津市第五中心医院呼吸科,天津300450 [6]天津医科大学第二医院呼吸科,天津300211 [7]天津市胸科医院呼吸科,天津300051

出　　处：《中国中西医结合急救杂志》2020年第3期267-270,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

摘　　要：目的 观察不同剂量血必净注射液对重型新型冠状病毒肺炎(简称新冠肺炎)的疗效.方法 选择2020年1月28日至2月16日作者作为天津市援鄂医疗队队员驰援武汉期间,在武汉市武钢第二医院隔离病房住院治疗的重型新冠肺炎患者23例作为研究对象,以2020年2月6日前入院的重型新冠肺炎患者为低剂量血必净组;2月6日后入院的重型新冠肺炎患者为高剂量血必净组.低剂量血必净组给予血必净注射液50 mL,每日2次;高剂量血必净组给予血必净注射液100 mL,每日2次;同时两组均给予抗病毒、抗细菌感染及小剂量糖皮质激素抗炎对症支持治疗.比较初始应用不同剂量血必净注射液治疗重型新冠肺炎患者的临床疗效、临床指标〔包括体温、动脉血氧饱和度(SaO2)、淋巴细胞计数(LYM)、白细胞计数(WBC)和C-反应蛋白(CRP)〕的变化及药物不良反应.结果 高剂量血必净组治疗总有效率高于低剂量血必净组〔91.7%(11/12)比81.8%(9/11)〕,但两组比较差异无统计学意义(P>0.05).治疗后高剂量血必净组SaO2(静息状态吸入空气条件下)的改善程度明显优于低剂量组〔0.96(0.95,0.97)比0.95(0.94,0.96),P<0.05〕.治疗7 d后两组体温均恢复至正常范围,高剂量血必净组LYM明显升高,但与低剂量血必净组比较差异无统计学意义〔×109/L:1.10(0.94,1.42)比1.31(0.47,1.49),P>0.05〕.两组CRP均无明显变化,比较差异亦无统计学意义(P>0.05).高剂量血必净组中有1例年轻患者出现消化道不良反应(恶心、呕吐),停药后症状消失,总体不良反应发生率为4.3%;低剂量血必净组中1例患者病情加重最终死亡.结论 初始应用血必净注射液100 mL、每日2次,联合阿比多尔、抗菌药物及小剂量糖皮质激素对症支持治疗重型新冠肺炎可有效改善患者症状和氧合,升高LYM.Objective To investigate the therapeutic effect of different doses of Xuebijing Injection on severe corona virus disease 2019(COVID-19).Methods During January 28 to February 16,2020,when the author was in Wuhan as a member of Tianjin Medical Team for Hubei Province,23 patients with severe COVID-19 hospitalized in the isolation ward of Second Hospital of Wisco,Wuhan were selected as research objects.According to the time of admission,the severe COVID-19 patients were divided into low-dose Xuebijing group(admitted before February 6,2020)and high-dose Xuebijing group(admitted after February 6,2020).The high-dose Xuebijing group was given Xuebijing Injection 50 mL,twice a day;the high-dose Xuebijing group was given Xuebijing Injection 100 mL,twice a day.At the same time,the two groups were given abidol antiviral therapy,antibacterial drugs and low-dose glucocorticoid symptomatic support treatment.The clinical therapeutic effects,changes of clinical indexes[including body temperature,arterial oxygen saturation(SaO2),lymphocyte count(LYM),white blood cell count(WBC)and C-reactive protien(CRP)]and adverse drug reactions of initial application of different doses of Xuebijing Injection on severe COVID-19 patients were observed.Results The total effective rate of high-dose Xuebijing group was higher than that in low-dose Xuebijing group,without significant difference[91.7%(11/12)vs.81.8%(9/11),P>0.05].After treatment,the improvement of SaO2 in resting state in high-dose Xuebijing group was more obvious than that in low-dose group[0.96(0.95,0.97)vs.0.95(0.94,0.96),P<0.05].After 7 days of treatment,the body temperature of both groups returned to the normal range,and LYM in high-dose Xuebijing group increased significantly,but without significant difference compared with low-dose Xuebijing group[×109/L:1.10(0.94,1.42)vs.1.31(0.47,1.49),P>0.05].There was no significant change in CRP of the two groups,without significant difference(P>0.05).In high-dose Xuebijing group,one case of young patient had digestive tract adverse react

关 键 词：新型冠状病毒肺炎 重型 血必净注射液 临床疗效 淋巴细胞 

分 类 号：R72[医药卫生—儿科]