血必净注射液对重症肺炎患者血清中IL-6、TNF-α的影响及意义思义

The Effect of Xuebijing Injection on IL-6,TNF-a Levels in Serum of Patients with Severe Pneumonia

目的探讨血必净注射液对重症肺炎患者血清中IL-6、TNF-α水平的影响及其临床意义。方法将28例患者随机分为血必净组（n=14）及对照组（n=14）。对照组予以机械辅助通气、抗感染等综合治疗，血必净组在综合治疗的基础上加用血必净注射液，血必净50mL加入生理盐水100mL静脉滴注30min，1次／12h，连用7d。留取治疗前后患者的外周静脉血，应用流式细胞小球微阵列（cytometricbeadarray，CBA）方法定量测定血清中IL．6、TNF-α的含量。结果两组患者治疗后血清IL-6、TNF-α水平均较治疗前明显下降（P〈0．01），血必净组IL．6、TNF-α水平下降较对照组更加显著（P〈0．05）。两组患者治疗后Pa02／Fi02均较治疗前显著提高（P〈0．01），且血必净组Pa02／Fi02改善情况优于对照组（P〈0．05）。两组患者治疗后CPIS均较治疗前明显下降（P〈0．01），血必净组CPIS下降较对照组更加明显（P〈O．05）。治疗7d内，血必净组有6例患者停用呼吸机，对照组2例停用呼吸机，差异有统计学意义（P〈0．05）。血必净组患者平均机械通气时间为11．5±2．0d，对照组为14．0±2．4d，差异有统计学意义（P〈0．05）。结论血必净注射液具有控制肺部炎症反应的作用，通过调节血清中细胞因子水平可能是其途径之一。

Objective To evaluate the effect of Xuebijing injection on interleukin-6（IL-6） and TNF- ct in serum in patients with severe pneumonia and it＇s clinical effect.Methods 28 patients with severe pneumonia were randomly divided into Xuebijing goup（n=14） and control group（n=14）.Two groups were both treated with mechanical ventilation,anti-infection and other treatments needed,the Xuebijing group were treated with Xuebijing injection additionally,Xuebijing injection 50mL＋NS 100mL intravenously dropped within 30 minutes,once per 12 hours for 7 days.The concentrations of IL-6 and TNF- a in serum were determined by cytometric bead array（CBA） before and after treatment.Results The concentrations of IL-6,TNF- ~x after treatment in two groups all decreased significantly（P 〈 t）.01）,the concentration of IL-6,TNF-a in Xuebijing group decreased more significantly than that in control group（P 〈 0.05）.The PaOJFiO2,CPIS after treatment in two groups all improved more significantly than those before treatment（P 〈 0.01）,and it＇s better in Xuebijing group than in control group（P 〈 0.05）.There number of withdraw ventilator patients in Xuebijing group was 6 versus 2 in control group,there was significant difference（P 〈 0.05）.The average mechanical ventilation time in Xuebijing group was 11.5 _ 2.0 days versus 14.0-2.4 days in control group,there was statistical difference（P 〈 0.05）.Conclusion Xuebijing injection can control the inflammation of pneumonia,reducing the levels of cytokines in serum maybe one of the mechanisms.