参附注射液对创伤失血性休克患者凝血功能和炎性因子的影响

Effect of Shenfu Injection on blood coagulation and inflammatory factors of patients with traumatic hemorrhagic shock

目的:研究参附注射液对创伤失血性休克患者凝血功能和炎性因子的影响。方法:选择98例创伤失血性休克患者,随机分为研究组和对照组,每组49例,两组均接受西医常规治疗,研究组在常规治疗的基础上加用参附注射液,检测两组患者凝血功能和炎性因子等各项指标。结果:治疗后,对照组纤维蛋白原(FIB)和国际标准化比值(INR)水平较治疗前降低(P<0.05),凝血酶原时间(PT)、凝血酶时间(TT)和活化部分凝血活酶时间(APTT)较治疗前延长(P<0.05);研究组PT和TT较治疗前降低,与治疗前比较差异有统计学意义(P<0.05),FIB、INR和APTT水平较治疗前升高,与治疗前比较差异无统计学意义(P>0.05);两组患者治疗后FIB、PT、APTT、TT和INR比较差异有统计学意义(P<0.05)。两组患者肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、白介素-10(IL-10)水平均较治疗前升高(P<0.05),两组患者治疗后炎性因子比较差异有统计学意义(P<0.05)。结论:参附注射液可改善创伤失血性休克患者的凝血功能和炎性因子水平,改善患者高凝状态,纠正休克后期的凝血功能紊乱,以减少休克后期弥散性血管内凝血(DIC)、多器官功能障碍综合征(MODS)、急性呼吸窘迫综合征(SIRS)的发生。

Objective： To study the effect of Shenfu Injection on blood coagulation and inflammatory factors of patients with traumatic hemorrhagic shock. Methods： A total of 98 cases of traumatic hemorrhagic shock were randomly divided into study group and control group by half. Patients in two groups received routine treatment of western medicine, patients in the study group had conventional treatment combined with Shenfu injection. Coagulation indexes and inflammatory factors of two groups were tested. Results： After the treatment, in control group fibrinogen （FIB） and international normalization ratio （INR） levels of control group were significantly reduced （P〈0.05）, while prothrombin time （PT）, thrombin time （TT） and activated partial thromboplastin time （APTT） levels were significantly increased after treatment （P〈0.05）. PT and TT levelsof study group were significantly reduced after treatment （P〈0.05）, FIB, INR and APTT levels were significantly increased （P〈0.05）. There were significant differences in FIB, PT, APTT, TT and INR level between two groups after treatment （P 〈0.05）. TNF-alpha, IL-6, IL-10 levels of two groups were significantly elevated after treatment （P〈0.05）. There were significant differences in the inflammatory factors between two groups （P〈0.05）. Conclusions： Shenfu injection can improve the blood coagulation status and inflammatory factors level of patients with traumatic hemorrhagic shock, improve the hypercoagu- lable state, correct coagulation disorders, and reduce the incidence of DIC, MODS, SIRS.