血必净注射液对重症肺炎合并急性呼吸窘迫综合征患者Murray肺损伤评分及血气指标的影响

Effect of Xuebijing injection on Murray lung injury score and blood gas index in patients with severe pneumonia complicated with acute respiratory distress syndrome

目的观察血必净注射液对重症肺炎合并急性呼吸窘迫综合征(ARDS)患者Murray肺损伤评分及血气指标的影响。方法纳入2017年1月-2019年12月四川省安岳县人民医院呼吸内科收治的重症肺炎合并ARDS患者86例展开研究,按照随机数字表法分为观察组和对照组,每组43例,对照组在常规治疗的基础上联合大剂量氨溴索治疗,观察组在对照组治疗的基础上联合血必净注射液治疗。比较2组症状消失时间、治疗前后血气分析指标、炎性因子水平、急性生理学及慢性健康状况(APACHEⅡ)评分、Murray肺损伤(MLIS)评分、临床肺部感染(CPIS)评分。结果观察组肺部啰音、喘息、缺氧症状消失时间均短于对照组(P<0.01)。治疗后,2组血氧分压(Pa O2)、氧合指数(Pa O2/Fi O2)、静态肺顺应性(Cst)均高于治疗前,且观察组高于对照组(P<0.01)。治疗后,2组C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、IL-8水平及APACHEⅡ评分、MLIS评分、CPIS评分均低于治疗前,且观察组低于对照组(P<0.01)。结论血必净注射液辅助治疗重症肺炎合并ARDS有助于改善血气分析指标、临床症状,降低炎性因子水平,控制患者的感染状况,减轻肺损伤,临床疗效较好。

Objective To observe the effect of Xuebijing injection on Murray lung injury score and blood gas indexes in patients with severe pneumonia complicated with acute respiratory distress syndrome(ARDS).Methods 86 patients with severe pneumonia combined with ARDS admitted to the department of Respiratory Medicine,Anyue County People’s Hospital,Sichuan Province from January 2017 to December 2019 were selected,and they were divided into observation group and control group according to the random number table method,43 cases in each group.The control group was treated with high-dose ambroxol on the basis of conventional treatment,and the observation group was treated with Xuebijing injection on the basis of the treatment of the control group.The symptom disappearance time,blood gas analysis indexes before and after treatment,inflammatory factor levels,acute physiology and chronic health status(APACHEⅡ)score,Murray lung injury(MLIS)score,clinical lung infection(CPIS)score of the two groups were compared.Results The disappearance time of pulmonary rales,wheezing,and hypoxia in the observation group was shorter than that in the control group(P<0.01).After treatment,the partial pressure of blood oxygen(Pa O2),oxygenation index(Pa O2/Fi O2),and static lung compliance(Cst)in the two groups were all higher than before treatment,and the observation group was higher than the control group(P<0.01).After treatment,the levels of C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),IL-8 and APACHEⅡscore,MLIS score,CPIS score of the two groups were all lower than before treatment,and the observation group were lower than the control group(P<0.01).Conclusion Xuebijing injection adjuvant treatment of severe pneumonia combined with ARDS can help improve blood gas analysis indicators,clinical symptoms,reduce inflammatory factor levels,control the patient’s infection status,reduce lung injury,and have a better clinical effect.