参附注射液对严重脓毒症患者肝肾功能的保护作用

A clinic study on Shenfu Injection for protection of hepato-renal function and mechanism in patients with severe sepsis

目的：研究参附注射液对严重脓毒症患者肝肾功能的保护作用及其机制。方法：将2009年6月~2010年6月入住重症医学科（ICU）的68例严重脓毒症患者随机分为对照组（32例）和参附注射液组（36例）,对照组给予常规治疗,参附组在常规治疗基础上给予参附注射液100ml加入5%葡萄糖250ml中静脉滴注,每天1次,持续7天。观察两组入ICU时（治疗前）及治疗后3、7d后血浆丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、尿素氮（BUN）、肌酐（Cr）、血清白介素-6（IL-6）、IL-10水平及外周血T细胞亚群（CD3＋、CD4＋、CD8＋）水平的变化;并记录比较两组急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）和多个器官功能障碍综合征（MODS）评分。结果：两组患者治疗后血ALT、AST、BUN、Cr、IL-6水平以及APACHEⅡ、MODS评分均呈下降趋势;治疗7d后,参附组上述指标明显下降,与对照组比较差异有统计学意义。相反,治疗后,两组患者外周血T细胞亚群水平有不同程度的升高,参附组在治疗7d明显回升,与对照组比较差异有统计学意义。结论：参附注射液能调节严重脓毒症患者促炎/抗炎平衡,增强细胞免疫功能,保护肝肾功能。

Objective： To study the mechanism and protection of Shenfu injection on hepato-renal function in patients with severe sepsis.Methods： Sixty-eight patients in the intensive care unit（ICU） from June 2009 to June 2010 were randomly Divided into control group（32 cases） and Shenfu group（36 cases）.The patients in the control group Received the conventional therapy,and the cases in the Shenfu group accepted 100ml of Shenfu injection with 250ml of 5% glucose administered through intravenous drip once a day.The treatment course was 7days.The plasma levels of alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,blood urea nitrogen（BUN）,creatinine kinase（Cr）,interleukin-6（IL-6） and IL-10 and peripheral T-lymphocyte subsets（CD 3 ＋,CD 4 ＋,CD 8 ＋T-lymphocytes） were detected on the day of admission（before treatment） and 3 days and 7 days after treatment in the two groups.The acute physiology and chronic health evaluation II（APACHE II） score and MODS score were recorded and compareded in the same time.Results： After treatment,ALT,AST,BUN,Cr,IL-6 and APACHEⅡ、MODS score of both groups showed ascending tendency,the above indexes in Shenfu group were decreased more significantly than those of control group after 7 days of treatment.On the other hand,the peripheral T-lymphocyte subsets increased to varying degrees.The increase of the above indexes in Shenfu group was more obvious 7 days after treatment,and there were statistical significant differences compared with those of control group.Conclusion： Shengfu injection can keep proinflammatory and anti-inflammatory cytokines on the balance,help to improve immunologic function significantly,and protect hepato-renal function markedly of patients with severe sepsis.