血必净注射液对毒蜘蛛咬伤患者器官功能损伤的保护作用  

Protective effect of Xuebijing injection on organ function injury of patients with poisonous spider bites

作　　者：李昭[1] 徐科 吐尔逊江 钟洁 隗沫 顾伟[1] Li Zhao;Xu Ke;Tuer Xunjiang;Zhong Jie;Wei Mo;Gu Wei(Emergency Medicine Center,Chuiyangliu Haspital Afiliated to Tsinghua University,Bejing 100022,China;Department of Emergency Medicine,Xinjiang Baczhou People's|Hospital,Korla 841000,Xinjiang Uygur Autonomous Region,China)

机构地区：[1]清华大学附属垂杨柳医院急救医学中心,北京100022 [2]巴州人民医院急诊科,新疆维吾尔自治区库尔勒841000

出　　处：《中国中西医结合急救杂志》2020年第6期697-700,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：北京市自然科学基金(7182055);北京市属医院科研培育计划(PX2016022)。

摘　　要：目的观察血必净注射液对毒蜘蛛咬伤患者临床疗效及炎症反应指标的影响.方法选择2014年5月至2017年9月笔者援疆期间在新疆维吾尔自治区巴州人民医院收治的50例毒蜘蛛咬伤患者作为研究对象.将患者分为常规治疗对照组和血必净治疗组,每组25例.常规治疗对照组按照毒蜘蛛治疗指南给予局部消毒、补液、激素疗法、抗过敏及器官功能支持等治疗;血必净治疗组在常规治疗对照组基础上将血必净注射液50 mL加入生理盐水250 mL中静脉滴注,每日2次,连用3 d.观察两组患者体温、呼吸频率(RR)、心率(HR)、白细胞计数(WBC)、急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)和血浆丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、肌酸激酶同工酶(CK-MB)等生化指标以及C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)等炎症指标的变化.结果治疗后,两组患者体温、RR、HR、WBC、ALT、AST、CK-MB、CRP、TNF-α、IL-6和APACHEⅡ均较治疗前降低;且血必净治疗组治疗后上述指标水平均较常规治疗对照组降低程度更明显〔体温(℃):36.22±1.24比37.46±1.44,RR(次/min):14.56±1.94比17.46±1.88,HR(次/min):77.46±14.58比93.28±19.24,WBC(×10^(9)/L):6.79±1.84比8.79±1.86,ALT(U/L):38.57±3.28比57.66±3.96,AST(U/L):43.46±4.15比53.35±3.76,CK-MB(U/L):16.38±2.92比20.32±2.18,CRP(mg/L):10.12±1.67比15.56±2.12,TNF-α(mg/L):41.76±7.86比67.52±8.75,IL-6(mg/L):13.72±4.76比21.32±5.45,APACHEⅡ(分):4.04±1.41比7.12±2.92〕,差异均有统计学意义(均P<0.05).结论在常规治疗基础上联合血必净注射液,既能较好地改善患者的生命基础体征和临床症状,又能降低炎症因子水平,抑制炎症反应;同时还能改善肝功能、心肌损伤标志物等生化指标,发挥器官功能保护作用.Objective To observe the elinical efficacy of Xuebijing injection in treating patients with poisonous spider bites and its effects on inflammatory reaction indexes.Methods Fifty patients with poisonous spider bites admitted to Xinjiang Uygur Autonomous Region Bazhou People's Hospital from May 2014 to September 2017 during the period of the author's assistance to Xinjiang were selected as research objects.The patients were divided into a Xuebijing treatment group and a routine treatment control group,with 25 cases in each group.The routine treatment control group was given local disinfection,rehydration,hormone therapy,anti allergy and organ function support according to the treatment guidelines of spider venom;in Xuebijing treatment group,50 mL Xuebijjing injection added into 250 mL normal saline for intravenous drip on the basis of treatment in conventional treatment control group was given to the patients,twice a day for 3 days.The changes in body temperature,respiratory rate(RR),heart rate(HR),white blood cell count(W BC),acute physiology and chronic health evaluation I(APACHE I),plasma alanine aminotransferase(ALT),aspartate aminotransferase(AST),creatine kinase isoenzyme(CK-MB),indicators of inflammatory response including C-reactive protein(CRP),serum tumor necrosis factor-a(TNF-a)and interleukin-6(IL-6)were observed in the two groups.Results After treatment,the body temperature,RR,HR,WBC,ALT,AST,CK-MB,CRP,TNF-α,IL-6 and APACHE II in the two groups were lower than those before treatment;the lowering degrees of above indexes in Xuebijing treatment group were more significant than those in routine treatment control group after treatment[body temperature(C):36.22±1.24 vs.37.46±1.44,RR(times/min):14.56±1.94vs.17.46±1.88,HR(bpm):77.46±14.58 vs.93.28±19.24.WBC(X 10^(9)/L):6.79±1.84 vs.8.79±1.86,ALT(U/L):38.57±3.28 vs.57.66±3.96,AST(U/L):43.46±4.15 vs.53.35±3.76,CK-MB(U/L):16.38±2.92 vs.20.32±2.18,CRP(mg/L):10.12±1.67 vs.15.56±2.12,TNF-α(mg/L):41.76±7.86 vs.67.52±8.75,IL-6(mg/D):13.72±4.76 vs.

关 键 词：血必净注射液 毒蜘蛛咬伤 生化指标 炎症因子 器官功能 

分 类 号：R54[医药卫生—心血管疾病]