血必净注射液对急性呼吸窘迫综合征患者肾上腺髓质素的影响

Effects of Xuebijing injection on adrenomedullin in patients with acute respiratory distress syndrome

目的探讨血必净注射液对急性呼吸窘迫综合征(ARDS)患者的治疗效果及对肾上腺髓质素(ADM)的影响。方法将64例ARDS患者随机分为对照组和治疗组,对照组为常规治疗组,治疗组加用血必净注射液治疗。观察两组治疗前后氧合指数及ADM的变化。结果治疗后两组氧合指数均较治疗前明显升高;治疗组氧合指数改善程度优于对照组(P=0.0403),差异有统计学意义;治疗后两组血浆ADM浓度较治疗前明显降低,分别为治疗组26.32±8.97 mmHg(P<0.0001),对照组31.10±8.94 mmHg(P=0.0016);治疗组血浆ADM浓度较治疗前降低更为明显(P=0.0185),差异有统计学意义。结论 ARDS患者血浆ADM水平较正常人明显升高,对ARDS患者具有保护作用,经治疗后,随着炎性反应的减轻,患者血浆ADM水平明显下降,应用血必净注射液可使ARDS患者获得额外的治疗效果,血浆ADM水平也可作为评价ARDS治疗效果的客观指标。

Objective To investigate the treatment effects of Xuebijing injection on acute respiratory distress syndrome （ARDS） patients, and effects on the concentration of plasma adrenomedullin （ADM）. Methods The ARDS patients were randomly divided into control group and treatment group, the control group was conventional treatment group, the treatment group were treated with Xuebijing injection. The changes of oxygenation index and plasma ADM concentration were observed before and after treatment in two groups. Results Oxygenation index of two groups was significantly elevated after treatment, the treatment group （P 〈 0. 0001 ）, the control group （ P 〈 0. 0001 ） respectively. Oxygenation index of treatment group is better than that of control group （P = 0.0403 ）, the difference was statistically significant. Plasma ADM concentration in the two groups after treatment significantly lower than before treatment, the treatment group （P 〈 0. 0001 ）, the control group （P = 0. 0016） respectively. Plasma ADM concentration decreased more obviously in treatment group （P = 0.0185 ）, the difference was statistically significant. Conclusions The plasma ADM concentration in patients with ARDS was higher than the normal adults and has protective effects on ARDS patients. With the inflammatory reaction relieved, the plasma ADM concentration of ARDS patients decreased significantly after treatment. The application of Xuebijing injection can obtain more additional treatment effect. It is recommended that Xuebijing injection was routinely applied in the treatment of ARDS patients and the plasma ADM concentration may be used as an objective index for evaluation of therapeutic effect of ARDS.