参麦注射液干预对脓毒症新发脏器损伤的影响  

Effect of Shenmai Injection intervention on new organ damages in sepsis

作　　者：杨思雯[1] 屠连茹[2] 李思耐 张羽[1] 张鑫 宋麦芬[1] 徐霄龙 王旭升[1] YANG Siwen;TU Lianru;LI Sinai;ZHANG Yu;ZHANG Xin;SONG Maifen;XU Xiaolong;WANG Xusheng(Department of Intensive Care Unit,Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010,China;Department of Traditional Chinese Medition Internal Medicine,Huguosi Traditional Chinese Medicine Hospital Affiliated to Beijing University of Traditional Chinese Medicine,Beijing 100035,China;Laboratory of Simultaneous Treatment of Brain and Heart,Beijing Institute of Traditional Chinese Medicine,Beijing 100010,China;Clinical Diagnosis,Treatment and Research Center for Traditional Chinese Medicine Sepsis,Beijing 100010,China)

机构地区：[1]首都医科大学附属北京中医医院重症医学科,北京100010 [2]北京中医药大学附属护国寺中医医院中医内科,北京100035 [3]北京市中医药研究所脑心同治实验室,北京100010 [4]中医脓毒症临床诊疗与研究中心,北京100010

出　　处：《中国医药导报》2024年第5期139-142,164,共5页China Medical Herald

基　　金：北京市属医院科研培育计划项目(PZ2023011)。

摘　　要：目的观察参麦注射液干预对脓毒症的新发脏器损伤的影响。方法选取2017年1月至2021年10月入住首都医科大学附属北京中医医院重症医学科(ICU)的181例成人脓毒症患者作为研究对象。根据患者是否出现新发脏器损伤将脓毒症患者分为新发脏器损伤组(95例)和无新发组(86例)。收集患者基本情况、前期相关实验室指标及干预因素、治疗7 d后实验室相关指标,构建多因素logistic回归模型分析相关发病因素,依据χ^(2)检验探索参麦注射液干预与新发脏器损伤的相关性。结果新发脏器损伤组入院72 h内休克、早期液体平衡量、入ICU及治疗后脓毒症相关性器官功能衰竭评价评分高于无新发组,差异有高度统计学意义(P<0.01)。新发脏器损伤组入院使用参麦注射液干预比例、治疗后血白蛋白水平及血红蛋白水平低于无新发组,差异有统计学意义(P<0.05)。参麦注射液干预(OR=0.261,95%CI:0.109~0.626,P<0.01)、治疗后血红蛋白(OR=0.978,95%CI:0.957~0.998,P<0.05)是新发脏器损伤的独立影响因素。参麦注射液干预后急性肾损伤、急性肺损伤患者少于未使用参麦注射液(P<0.01)。参麦注射液干预后新发急性心功能不全与未使用参麦注射液比较,差异无统计学意义(P>0.05)。结论参麦注射液干预可以降低脓毒症并发急性肺损伤、急性肾损伤等新发脏器损伤风险。Objective To observe the effect of Shenmai Injection intervention on the prognosis of sepsis and new organ damage.Methods A total of 181 adult sepsis patients admitted to the Intensive Care Unit(ICU)of Beijing Hospital of Traditional Chinese Medicine,Capital Medical University from January 2017 to October 2021 were selected as the subject Sepsis patients were divided into a newly diagnosed organ injury group(95 cases)and non-diagnosed organ injury group(86 cases)according to whether patients had new organ injury or not.The basic information of patients,relevant laboratory indicators,and intervention factors in the early stage,and relevant laboratory indicators after 7 d of treatment were collected.Multivariate logistic regression model was constructed to analyze the relevant pathogenesis factors,and the correlation between Shenmai Injection intervention and new organ injury was explored according toχ^(2)test.Results The levels of shock within 72 h after admission,early fluid balance,sepsis-related organ failure assessment score admission to ICU and after treatment,and white blood cell count in the newly diagnosed organ injury group were higher than those in the non-diagnosed organ injury group,and the differences were highly statistically significant(P<0.01).The proportion of Shenmai injection used in hospital,the levels of blood albumin and hemoglobin after treatment in the newly diagnosed orgain injury group were lower than those in the non-diagnosed organ injury group,and the differences were statistically significant(P<0.05).Shenmai Injection intervention(OR=0.261,95%CI:0.109-0.626,P<0.01)and hemoglobin after treatment(OR=0.978,95%CI:0.957-0.998,P<0.05)were independent influencing factors of new organ injury.The patients with acute kidney injury and acute lung injury after Shenmai Injection intervention were less than those without Shenmai Injection(P<0.01).There was no significant difference between Shenmai Injection and no Shenmai Injection in patients with new acute cardiac dysfunction(P>0.05).Conclusion

关 键 词：参麦注射液 脓毒症 新发脏器损伤 急性肺损伤 急性肾损伤 

分 类 号：R278[医药卫生—中医学]