灯盏花素对脓毒症急性肺损伤患者的保护作用及机制研究  

Protective effect and mechanism of Breviscapine on patients with sepsis induced acute lung injury

作　　者：周莹 吴爽 柯慧娟 孙鹏飞[1] 陆晓娟 陈琛[1] 于英华[1] 李天民[1] Zhou Ying;Wu Shuang;Ke Huijuan;Sun Pengfei;Lu Xiaojuan;Chen Chen;Yu Yinghua;Li Tianmin(Department of Intensive Care Unit,the First Affiliated Hospital of Hebei North University,Zhangjiakou 07500o,Hebei,China)

机构地区：[1]河北北方学院附属第一医院重症医学科,河北张家口075000

出　　处：《中国中西医结合急救杂志》2022年第3期288-291,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：河北省医药卫生科研项目(20200526)。

摘　　要：目的 探讨灯盏花素对脓毒症急性肺损伤(ALI)患者的保护作用及可能作用机制.方法 选择2020年10月至2021年10月河北北方学院附属第一医院重症医学科收治的60例脓毒症合并ALI患者,按随机对照原则将患者分为西医常规治疗组和灯盏花素组,每组30例.两组均给予抗感染、肺保护性通气、液体复苏等常规治疗;灯盏花素组在常规治疗基础上给予灯盏花素注射液(40 mg稀释到5%葡萄糖溶液里,每日1次静脉滴注).治疗10 d后比较两组氧合指数(PaO2/FiO2)、白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)、 超氧化物歧化酶(SOD)水平,并评价用药安全性.结果 随时间延长,两组治疗后7 d、10 d PaO2/FiO2和SOD活性均较治疗前明显升高〔PaO2/FiO2(mmHg,1 mmHg≈0.133 kPa):西医常规治疗组为203.62±22.83、250.49±27.70比75.42±5.79,灯盏花素组为272.13±20.77、311.16±23.29比78.76±6.22;SOD(kU/L):西医常规治疗组为88.33±6.68、95.61±7.57比79.57±10.62,灯盏花素组为110.94±7.20、122.42±8.04比76.06±8.28,均P<0.05〕,IL-6、TNF-α水平均较治疗前明显降低〔IL-6(ng/L):西医常规治疗组为214.33±25.30、176.63±27.26比263.16±27.26,灯盏花素组为168.13±20.29、139.46±23.70比271.86±35.09;TNF-α(ng/L):西医常规治疗组为229.55±32.51、153.14±29.63比322.43±44.81,灯盏花素组为160.20±35.84、107.25±24.88比317.24±41.56,均P<0.05〕;且灯盏花素组治疗7 d、10 d后PaO2/FiO2和SOD活性明显高于西医常规治疗组〔PaO2/FiO2(mmHg):治疗后7 d为272.13±20.77比203.62±22.83,治疗后10 d为311.16±23.29比250.49±27.70;SOD(kU/L):治疗后7 d为110.94±7.20比88.33±6.68,治疗后10 d为122.42±8.04比95.61±7.57,均P<0.05〕,IL-6、TNF-α水平均明显低于西医常规治疗组〔IL-6(ng/L):治疗后7 d为168.13±20.29比214.33±25.30,治疗后10 d为139.46±23.70比176.63±27.26;TNF-α(ng/L):治疗后7 d为160.20±35.74比229.55±32.51,治疗后10 d为107.25±24.88比153.14±29.63,均P<0.05〕,以治�Objective To explore the protective ffect and possible mechanism of Breviscapine on patients with sepsis induced acute lung injury(ALI)..Methods.Sixty patients with septic ALI admited to department of intensive care unit(ICU)of the First Affiliated Hospital of Hebei North University from October 2020 to October 2021 were enroled.According to the principle of randomized control,the patients were divided into western medicine conventional treatment group and Breviscapine group,with 30 cases in each group.Both groups received routine treatment such as antiinfection,lung protective ventilation and fluid resusciation,while Breviscapine group received additionally Breviscapine injection(40 mg diluted to 5%glucose solution,once a day intravenously)on the basis of conventional treatment.After 10 days of treatment,the levels of oxygenation index(PaO,/FiO_(2)),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and superoxide dismutase(SOD)were compared and safety were evaluated in both groups.Results_With the prolongation of time,the PaO,/FiO,and SOD activity were significantly higher than those before treatment[PaO/FiO,(mmHg,I mmHg~0.133 kPa):westerm medicine conventional treatment group was 203.62±22.83,250.49±27.70 vs.75.42±5.79,Breviscapine group was 272.13±20.77,311.16±23.29 vs.78.76±6.22;SOD(kU/L):westem medicine conventional treatment group was 88.33±6.68,95.61±7.57 vs.79.57±10.62,Breviscapine group was 110.94±7.20,122.42±8.04 vs.76.06±8.28,all P<0.05],while the levels of IL-6 and TNF-αin both groups were significantly lower at 7 days and 10 days after treatment those than before treatment[IL-6(ng/L):western medicine conventional treatment group was 214.33±25.30,176.63±27.26 vs.263.16±27.26,Breviscapine group was 168.13±20.29,139.46±23.70 vs.271.86±35.09;TNF-α(ng/L):western medicine conventional treatment group was 229.55±32.51,153.14±29.63vs.322.43±44.81,Breviscapine group was 160.20±35.84,107.25±24.88 vs.317.24±41.56,ll P<0.05].The PaO/FiO,and SOD activity were significantly higher than

关 键 词：灯盏花素 脓毒症 急性肺损伤 肿瘤坏死因子-Α 超氧化物歧化酶 

分 类 号：R459.7[医药卫生—急诊医学] R563[医药卫生—治疗学]