早期参附注射液对老年重症肺炎患者降钙素原及脑钠肽的影响

The influence of early application of Shenfu injection on procalcitionin and brain natriuretic peptide in elderly patients with severe pneumonia

[目的]观察早期应用参附注射液对老年重症肺炎患者降钙素原(PCT)及脑钠肽(BNP)的影响。[方法]84例老年重症肺炎患者按随机数字表法分为对照组与参附注射液组。对照组(42例)接受常规综合治疗(抗菌药物、呼吸机通气、营养支持等),参附注射液组(42例)在此基础上全程加用参附注射液。分别在治疗前、治疗后1 d、3 d、5 d检测血浆BNP和PCT。结合患者7 d内的病情情况分析参附注射液对老年重症肺炎的治疗效果、对血浆BNP及PCT的影响。[结果]与对照组比较,参附注射液组治疗后1 d PCT和BNP差异无统计学意义(P>0.05)。3 d和5 d参附注射液组PCT和BNP水平均低于对照组,差异有统计学意义(P<0.05)。3 d和5 d参附注射液组APACHEⅡ评分均低于对照组,差异有统计学意义(P<0.05)。治疗后7 d对照组好转10例,迁延17例,死亡15例;参附注射液组好转19例,迁延14例,死亡9例,差异有统计学意义(P<0.05)。两组中医证候比较,参附注射液组的总有效率为90.5%,明显高于对照组83.3%。[结论]早期应用参附注射液降低老年重症肺炎患者体内PCT及BNP水平,促进患者的转归。

[Objective] To investigate the influence of early application of Shenfu injection on procalcitionin（PCT）and brain natriuretic peptide（BNP） in elderly patients with severe pneumonia. [Methods] Eghtity-four elderly patients with severe pneumonia were divided into Shenfu injection group（42 cases） and control group（42 cases）.The control group received basic treatment（anti-inflammatory and nutritional support etc）. While the Shenfu injection group received early application of Shenfu injection therapy besides basic treatment. PCT and BNP level were measured before and after 1 d, 3 d, 5 d;and the effects of early application of Shenfu injection on PCT and BNP in elderly patients with severe pneumonia were analyzed combining the patients condition within 7 d. [Results]Compared with the control group, there were no significant difference in the PCT and BNP level after 1 d in Shenfu injection group（P〉0.05）. The PCT and BNP level were lower in Shenfu injection group than those in control group after 3d and 5d（P〈0.05）. The score of APACHE II was better than those in control group after 3 d and 5 d（P〈0.05）.Ten cases were improved, 17 cases progressed and 15 cases died in the control group, while 19 cases were improved,14 cases progressed and 9 cases died in Shenfu injection group after 7 d. Compare with the traditional Chinese medicine syndromes between the two groups, the total effective rate（90.5%） in Shenfu injection group was higher than in control group. [Conclusion] Early application of Shenfu injection can inhibit the PCT and BNP level in elderly patients with severe pneumonia and improve the prognosis.