复方丹参对急性肺损伤患者血小板活化因子表达及凝血功能的影响

Effects of compound salvia miltiorrhiza parenteral solution on platelet - activating factor （PAF） expression and blood coagulation function in acute lung injury （ALI） patients

目的探讨复方丹参注射液对急性肺损伤（ALI）患者血清血小板活化因子（PAF）表达及凝血系统功能的影响。方法ALI患者40例，随机分为对照组和治疗组，每组各20例，对照组予以治疗原发病、机械通气、激素治疗、抗感染、维持水电解质及酸碱平衡等常规治疗。治疗组在常规治疗的基础上加用复方丹参注射液20mL溶于5％葡萄糖注射液250mL中静脉滴注，1次／d，共3d。分别于治疗前及治疗3d后测定血清PAF、血栓素B2（TXB2）和凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、纤维蛋白原（FIB）、血小板参数及血气分析。比较对照组和治疗组治疗前后血清PAF、TXB2和PT、APTT、FIB、血小板参数及血气分析变化。结果与治疗前比较，治疗后两组氧合均改善，PAF和TXB2下降，胛、APTT延长，FIB下降，血小板参数改善（均P〈0．01）。与对照组比较，治疗组治疗后氧合显著改善，PAF和TXB，显著下降，PT、AFTT显著延长，FIB显著升高，血小板参数显著改善（P〈0．01或P〈0．05）。但两组病死率比较差异无统计学意义（P〉0．05）。结论复方丹参能减少ALI患者PAF的表达，改善ALI患者高凝状态和氧合，为临床早期治疗ALI提供了新方法。

Objective To investigate the effects of compound salvia mihiorrhiza parenteral solution on PAF expression and blood coagulation function in ALl patients. Methods 40 patients of ALl were randomly divided into two groups： control group （20 cases ） and treatment group （20 cases ）. The basic treatments of two groups included primary disease treatment, anti - infection, keeping the balance of water - electrolyte, adrenal cortical hormone treatment and mechanical ventilation. The treatment group was supernumerarily injected with compound salvia mihiorrhiza parenteral solution 20mL and 5% glucose solution injection 250mL for 3d. Serum PAF and thromboxane B2 （TXB2 ） level, prothrombin time （PT） , activated partial thromboplastin time （ APTF）, fibrin （ Fib）, parameter of blood platelets and blood gas analysis were measured before the treatment and 3 days after the treatment. PAF and TXB2 , PT, APTT, parameter of blood platelets and blood gas analysis of two groups were compared before and after the treatment. Results Compared with those before the treatment, the oxygenation were improved, PAF and TXB2 level decreased, PT and APTT increased, Fib decreased and parameter of blood platelets improved in both groups after the treatment（P 〈0.01 ）. Compared with control group, the oxygenation were improved, PAF and TXB2 level decreased, PT and APTT increased, Fib increased and parameter of blood platelets improved in treatment group. However, the mortality between two groups had no significant difference （ P 〉 0.05 ）. Conclusion Compound salvia miltiorrhiza parenteral solution could decrease the expression of serum PAF in ALI patients. It could also improve coagulation function of ALI and oxygenation. So, it could be a new approach for early clinical treatment of ALI.