血必净注射液治疗急性呼吸窘迫综合征临床研究

Therapeutic effects of Xuebijing injection on patients with acute respiratory distress syndrome

目的:观察血必净注射液治疗急性呼吸窘迫综合征(ARDS)临床疗效及对炎症相关细胞因子和凝血功能的影响。方法:选择本院重症医学科2008年8月至2010年8月收治的ARDS患者59例,随机分为对照组(29例)和试验组(30例)。两组患者均参照2006年中华医学会重症医学分会颁布的急性肺损伤/急性呼吸窘迫综合征诊断治疗指南接受治疗,试验组在此基础上加用血必净注射液50mL静脉滴注,每8h一次,7d为1个疗程。分别于治疗前、治疗后第1天、第4天、第7天观察凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血小板计数(PLT)、纤维蛋白原(FIB)、C反应蛋白(CRP)、血清中肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)含量及血气分析指标并记录各时间点A-PACHEⅡ评分和MLIS评分。结果:与对照组比较,试验组TNF-α、IL-6、IL-8、PT、APTT、二氧化碳分压(PCO2)、CRP于第4、第7天均明显降低,差异有统计学意义(P<0.05);FIB、PLT于第4、第7天均明显升高,差异有统计学意义(P<0.05);动脉血氧分压(PaO2)、PaO2/FiO2在血必净治疗后第7天均明显改善,差异有统计学意义(P<0.05),但APACHEⅡ评分和MLIS评分值比较差异无统计学意义。结论:血必净注射液可拮抗ARDS患者的炎症因子,改善凝血和呼吸功能,从而对ARDS患者有一定的辅助治疗作用。

AIM. To observe the effect of Xuebijing injection on cytokine, coagulation function, and pulmonary function in patients with acute respiratory distress syndrome （ARDS）. METHODS： From February 2008 to February 2010, a clinical study was conducted on consecutive adult patients with ARDS in department of intensive care medicine. The pa dents were divided into test group （30 patients） and control group （29 patients）. Both groups were treated with the routine therapy of ARDS according to the ALI/ARDS guidelines of Society of Critical Care Medicine 2006, and in addition, Xuebijing injection was used in a dose of 50mL three times a day for 7 days in test group. Acute physiology and chronic health evaluation II （APACHE II ） score, modified lung injury score（MLIS）, partial pressure of oxygen（PaO2 ）, partial pressure of earbondioxide（PCO2） and oxygenenation index （PaO2/FiO2 ） were recorded, and contents of interleukin （TNF-α, IL-6, IL-8） and prothrombin time （PT）, activated partial thromboplastin time （APTT）, platelet count （PLT）, fibrinogen （ FIB）, C-reactive protein （CRP） were measured on before and the 1st, 4th, 7th days after therapy both two groups. RESULTS. A significant improvement of TNF-a, IL-6, IL-8, PT, APTT, PCO2, CRP, FIB, PLT was observed, compared with that in the control group on 4th, 7th days after treatment （P 0.05）. The levels of PaO2 and PaO2/FiO2 were higher in the test group than that in the control group on the 7th day after treatment（P〈0.05）. While the APACHE II score and MLIS score between two groups had no significant difference. CONCLUSION. Xuebijing injection can play an adjuvant therapy role on ARDS by improve coagulation function, pulmonary function and de- creasing the contents of TNF-α,IL-6, IL-8 in serum.