血必净注射液对脓毒症急性肾损伤患者脏器功能及炎症因子的影响研究  

Effect of Xuebijing Injection on Viscera Function and Inflammatory Factors in Patients with Sepsis with Acute Kidney Injury

作　　者：朱冬菊[1] 吴祥[2] ZHU Dongju;WU Xiang(Clinical Medical College of Panzhihua University,Panzhihua 617000,China;不详)

机构地区：[1]攀枝花学院临床医学院,四川攀枝花617000 [2]攀枝花市中心医院

出　　处：《中外医学研究》2020年第32期4-7,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：攀枝花学院校级课题项目(2017YB012)。

摘　　要：目的:探讨血必净注射液对脓毒症急性肾损伤患者脏器功能及炎症因子的影响。方法:回顾性分析攀枝花学院附属医院及攀枝花中心医院2016年2月-2018年12月收治的292例脓毒症急性肾损伤患者的病例资料,根据治疗方案中是否使用血必净注射液将其分为对照组(152例)和观察组(140例)。对照组按脓毒症指南予以综合治疗,观察组在综合治疗基础上给予血必净注射液,疗程为7 d。比较两组治疗前后脏器功能指标,包括氧和指标[中心静脉血氧饱和度(ScvO2)、氧合指数(PaO2/FiO2)]、循环功能指标[心率(HR)、平均动脉压(MAP)]和肾功能指标[尿量、血肌酐(Scr)],同时比较两组治疗前后相关炎症指标[降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)],统计两组治疗总有效率、28 d死亡率、ICU住院天数、住院治疗费用。结果:治疗前两组HR、MAP、PaO2/FiO2、ScvO2、尿量、Scr比较差异均无统计学意义(P>0.05),治疗7 d后,观察组HR、Scr均低于治疗前及对照组治疗后,MAP、PaO2/FiO2、ScvO2及尿量均高于治疗前及对照组治疗后,差异均有统计学意义(P<0.05)。治疗前两组PCT、TNF-α、IL-6比较差异均无统计学意义(P>0.05),治疗7 d后,观察组各指标均低于对照组,差异均有统计学意义(P<0.05)。观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05),两组28 d死亡率比较差异无统计学意义(P>0.05)。观察组ICU住院时间短于对照组,住院费用低于对照组,差异均有统计学意义(P<0.05)。观察组治疗期间未发生与药物相关的便血等不良反应。结论:血必净注射液用于脓毒症AKI患者的治疗,可有效改善脏器功能及体内炎症状态,缩短ICU住院时间,降低住院费用,且不良反应发生较少,值得临床进一步推广。Objective:To observe the effect of Xuebijing Injection on viscera function and inflammatory factors in patients with sepsis with acute kidney injury.Method:A retrospective analysis was performed on 292 cases of sepsis patients with acute kidney injury admitted to the Affiliated Hospital of Panzhihua University and Panzhihua Central Hospital from February 2016 to December 2018.The patients were divided into the control group(152 cases)and the observation group(140 cases)according to the treatment regimen whether or not to use Xuebijing Injection.The control group was given comprehensive treatment according to sepsis guidelines,while the observation group was given Xuebijing Injection on the basis of comprehensive treatment,with a course of 7 days.Viscera function indicators were compared between the two groups before and after treatment,including oxygen and indicators[central venous oxygen saturation(ScvO2),oxygenation index(PaO2/FiO2)],circulatory function indicators[heart rate(HR),mean arterial pressure(MAP)]and renal function indicators[urine volume,serum creatinine(Scr)].At the same time,relevant inflammatory indicators[procalcitonin(PCT),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)]before and after treatment in the two groups were compared,and the total effective rate of treatment,28 d mortality,length of stay in ICU,and cost of hospitalization in the two groups were calculated.Result:Before treatment,there were no statistically significant differences in HR,MAP,PaO2/FiO2,ScvO2,urine volume and Scr between the two groups(P>0.05).After 7 days of treatment,HR and Scr in the observation group were all lower than those before treatment and those after treatment in the control group,MAP,PaO2/FiO2,ScvO2 and urine volume were all higher than those before treatment and those after treatment in the control group,the differences were statistically significant(P<0.05).There were no statistically significant differences in PCT,TNF-αand IL-6 between the two groups before treatment(P>0.05).After 7 days of treatmen

关 键 词：血必净注射液 脓毒症 脏器功能障碍 急性肾损伤 

分 类 号：R459.7[医药卫生—急诊医学]