血必净注射液对重型颅脑创伤后肺部感染患者血浆炎症介质表达的影响

Effect of Xuebijing injection on expressions of plasma mediators of inflammation in patients with pulmonaryinfection after severe traumatic craniocerebral injury

目的探讨血必净注射液对重型颅脑创伤（sTBI）后肺部感染患者血浆白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）表达的影响。方法将85例sTBI后肺部感染患者按随机原则分为对照组（42例）和治疗组（43例）。两组均给予常规治疤治疗组在常规治疗基础上加用血必净注射液，连续治疗7d。观察两组患者体温、白细胞计数（WBC）恢复正常以及影像学检查基本正常和肺部哕音消失的例数；采用放射免疫法测定两组患者不同时间点的血浆IL-6、TNF-α含量。结果治疗组患者体温、WBC恢复正常的例数以及影像学检查基本正常和肺部哕音消失的例数均较对照组明显增多[体温恢复正常（例）：38比26，WBC恢复正常（例）：54比22，影像学检查基本正常及肺部哕音消失（例）：35比23，均P〈0．01]。治疗组治疗前及治疗后1d血浆IL-6（ng／L）、TNF-01（ng／L）水平与对照组同期比较差异均无统计学意义（IL-6治疗前：40．7±12．6比41．3±11．5，治疗后1d：59．8±10．5比40．5±9．7；TNF-α治疗前：73．4±11．5比72．8±15．3，治疗后1d：74．1±11．8比73．6±14．2，均P〉0．05），两组治疗后4d、7d均较治疗前明显降低，且治疗组降低程度较对照组更显著（IL-6治疗后4d：22．1±7．4比25．6±6．6，治疗后7d：9．6±5．2比17．1±8．5；TNF-α治疗后4d：41．6±12．6比50．5±11．2，治疗后7d：27．9±9．8比37．2±8．5，P〈0．05或P〈0．01）。结论血必净注射液可降低sTBI后肺部感染患者IL-6、TNF-α水平，从而对sTBI患者起到一定的辅助治疗作用。

Objective To observe the effect of Xuebijing injection on the expressions of interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-α） in plasma in patients with pulmonary infection after severe traumatic brain injury （sTBI）. Methods Eighty-five patients with pulmonary infection after sTBI were randomly assigned to the control group （42 cases） and the treatment group （43 eases）. Conventional treatment was given to both groups, while in the treatment group, Xuebijing injection was additionally given for consecutive 7 days. The numbers of eases with body temperature, white blood cell count （WBC）, and imaging studies basically returned to normal and disappearance of pulmonary tales were observed, and the expression levels of IL-6 and TNF-α in plasma were detected by radioimmunoassay method at different time points in both groups. Results Compared with the control group, the numbers of cases with body temperature and WBC recovered to normal and the number of eases with imaging studies basically normal and the disappearance of pulmonary tales were significantly higher in the treatment group than those in the control group [ body temperature returned to normal （cases） ： 38 vs. 26, WBC returned to normal （cases） ： 34 vs. 22, imaging studies returned to normal and pulmonary rales disappeared （cases） ： 35 vs. 23, all P〈0.01 ] . Compared with the control group at the same time, the plasma IL-6 and TNF-α levels before treatment and 1 day after treatment had no significant difference [ IL-6 （ng/L）before treatment ： 40.7±12.6 vs. 41.3±1.5, 1 day after treatment ： 39.8±10.3 vs. 40.5±9.7 ; TNF-α （ng/L） before treatment ： 73.4±1.5 vs. 72.8±13.3, 1 day after treatment ： 74.1±1.8 vs. 73.6± 14.2, all P〉0.05 ] . On the 4th and 7th day after treatment in both groups, the expression levels of IL-6 and TNF-α were obviously lower than those before treatment, and the levels were decreased more significantly in the treatment group than those in the control group [ IL-6 （ng/L） 4th day after treatment ： 22.1±7.4 vs. 25.6±6.6,7th day after treatment ： 9.6±5.2 vs. 17.1±8.5 ; TNF-ot （ng/L） 4th day after treatment ： 41.6±12.6 vs. 50.5±1.2.7th day after treatment ： 27.9±9.8 vs. 37.2±8.5, P〈0.05 orP〈0.01 ] . Conclusion Xuebijing injection can reduce the levels of IL-6 and TNF-α in patients with pulmonary infection after sTBI, thus this agent has certain auxiliary therapeutic effect on them.