血必净注射液对重症急性胰腺炎治疗中炎症因子的影响

Effects of Xuebijing injection on inflammatory factors in treatment of severe acute pancreatitis

目的观察血必净注射液对重症急性胰腺炎(SAP)治疗过程中炎症因子的影响。方法入选SAP患者64例,随机分为对照组(n=32)和血必净组(n=32)。对照组行常规治疗,血必净组除常规治疗外,加用血必净注射液50 mL静脉滴注,每日2次,疗程为7 d。两组病例均于治疗前和治疗后第3、7日取血,测定血浆内毒素、C反应蛋白(CRP)含量和血清中炎症因子(TNF-α和IL-1、IL-6、IL-8)水平,进行急性生理学及慢性健康状况Ⅱ(APACHEⅡ)评分。结果治疗3 d后,对照组APACHEⅡ评分和CRP含量明显下降(P<0.05),内毒素和炎症因子水平有下降趋势但与治疗前无显著差异(P>0.05);血必净组APACHEⅡ评分、CRP含量和炎症因子水平均显著降低(P<0.01),与对照组有非常显著差异(P<0.01)。治疗7 d后,两组各指标均较治疗前明显降低(P<0.05),血必净组比对照组下降更显著(P<0.01)。血必净组有1例患者出现头痛、恶心,其他患者治疗过程中未见不良反应。结论血必净治疗可降低SAP血清内毒素水平,抑制炎症因子的释放,进而减轻SAP病情严重程度。

AIM To explore the changes of serum inflammatory factors after Xuebijing injection in patients with severe acute pancreatitis （SAP）. METHODS Totally 64 patients with SAP were randomly divided into two groups： control group （n = 32） and Xuebijing group （n = 32）. The control group was routinely treated only. Based on routine method, 7 days. Before the treatment and the Xuebijing group was added with Xuebijing injection 50 mL, twice a day for after 3, 7 days of the treatment, serum levels of endotoxin, C-reactive protein （CRP）, tumor necrosis factor-alpha （TNF-c~）, and interleukins 1, 6, 8 of the two groups were measured respectively, in the meanwhile, the Acute Physiology and Chronic Health Evaluation 1] （APACHE II ） scores were also evaluated. RESULTS After 3 days of the treatment, the APACHE II scores and the levels of serum CRP in the control group significantly decreased compared with those before the treatment （P 〈 0.05） and the levels of endotoxin and inflammatory factors had a downward trend with no significant differences （P 〉 0.05） ; the APACHE II socres and the levels of serum CRP and inflammatory factors were all significantly decreased in Xuebijing group （P 〈 0.01 ） which also had significant differences compared with those of the control group （P 〈 0.01 ）. After 7 days of the treatment, there were significant differences on changes of this indexes in the two groups （P 〈 0.05）, and the decrease in the Xuebijing group was more obvious than the control group （P 〈 0.01 ）. One patient suffered from a headache with nausea in the Xuebijing group, while no other drug adverse reactions were observed. CONCLUSION Xuebijing injection can significantly lower the degree of SAP through reducing the level of endotoxin and inhibiting the release of inflammatory factors.